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Leukemia-associated changes identified by quantitative flow cytometry: I. CD10 expression
T Lavabre-Bertrand1, G Janossy, K Ivory
1Department of Clinical Immunology, Royal Free Hospital and School of Medicine, Hampstead, London, United Kingdom.
Insights
CD10 antigen expression differs between normal fetal bone marrow and B-lineage acute lymphoblastic leukemia (ALL). Quantitative immunofluorescence revealed aberrant CD10 overexpression in a significant portion of ALL cases, correlating with specific chromosomal alterations.
Area of Science:
- Immunology
- Hematology
- Oncology
Background:
- CD10 antigen is a marker used in hematological diagnostics.
- Understanding CD10 expression patterns is crucial for diagnosing and classifying B-lineage acute lymphoblastic leukemia (ALL).
Purpose of the Study:
- To compare CD10 antigen expression levels in normal fetal bone marrow with those in B-lineage ALL.
- To investigate the diagnostic utility of CD10 quantification in ALL, including its correlation with chromosomal abnormalities.
Main Methods:
- Quantitative indirect immunofluorescence (QIFI) and direct immunofluorescence (IF) assays were employed.
- Median fluorescence intensity (MFI) values were converted to antigen molecules per cell (AgE) for precise quantification.
- Multiparameter flow cytometry was used for routine analysis of CD10 expression in leukemia cases.
Main Results:
- Normal lymphoid precursors express 3-12.5 x 10^3 CD10 molecules/cell.
- A significant percentage of B-lineage ALL cases (33% by QIFI, 43.6% by routine analysis) showed aberrant CD10 overexpression.
- Elevated CD10 levels correlated with hyperdiploidy, while low or undetectable levels were associated with specific translocations (t(1;19), t(4;11)).
Conclusions:
- CD10 antigen quantification is a valuable tool for diagnosing B-lineage ALL, particularly in challenging cases like early relapse or aplastic anemia masquerades.
- Aberrant CD10 expression patterns and levels provide insights into specific ALL subtypes and their associated genetic alterations.
- CD10 expression levels remain consistent in relapse, reinforcing its utility as a diagnostic marker.
Abstract:
We have compared CD10 antigen expression in normal fetal bone marrow with that of B-linage acute lymphoblastic leukemia (ALL). Both quantitative indirect immunofluoresence (QIFI) and direct immunofluorescence (IF) tests with Quantum beads were used to convert median fluorescence intensity (MFI) values into numbers of antigen molecules expressed per cell (AgE). Lymphoid precursors in the fetal marrow and liver expressed 3-12.5 x 10(3) CD10 molecules/cell with an upper limit of 5 x 10(4)/cell (MaxAgE). The median CD10 AgE in the different cases of acute B-lineage ALL were variable and ranged from undetectable to very high values (> 1.8 x 10(5). In 24 of the 72 cases (33%) tested with QIFI the median CD10 AgE was above the highest values seen in normal samples (> 5 x 10(4)/cell). An additional 23.6% of cases had higher median values than the normal median CD10 AgE. Next, CD10 antigen was quantitated in 78 cases during the routine multiparameter analysis of B-lineage leukemia using CD10/class II/CD34 3-color IF test or CD10/TdT 2-color IF test. The aberrant overexpression was confirmed in 43.6% of ALL cases. The CD10bright display suggested ALL diagnosis even when few cells were available for study, e.g., in early relapse and in ALL masquerading as aplastic anemia. The levels of CD10 expression were maintained in relapse. In addition, different CD10 levels were associated with the various chromosomal alterations: high CD10 levels (> 3 x 10(4)/cell) with hyperdiploidy, low CD10 levels (1.8-4 x 10(3)/cell) with the t(1;19) and undetectable levels (< 1.2 x 10(3)/cell) with the t(4;11) translocations.(ABSTRACT TRUNCATED AT 250 WORDS)
