Flowcytometric Immunophenotypic Profile of Acute Leukemia: Mansoura Experience

Abstract

Acute leukemia (AL) displays characteristic patterns of antigen expression, which facilitate their identification and proper classification. The purpose of this study is to evaluate the diagnostic usefulness of commonly used immune-markers for immunophenotyping of AL and to define the best immune-markers to be used for proper diagnosis and classification of AL. Besides, to recognize the frequency of different AL subtypes and the antigen expression profile in our Egyptian patients. We retrospectively analyzed the immunophenotypic data of 164 de novo AL patients from our institution during 2009 and 2010. Among these patients, 68.9% were classified as acute myeloblastic leukemia (AML) while 31.1% classified as acute lymphoblastic leukemia (ALL). The commonest FAB subtype in AML group was AML-M4/5 (34.5%) which may differ from most published data. As regard ALL, there were 74.5% with B-ALL and 25.5% with T-ALL. It was found that combined use of HLADR and CD34 was much more helpful in distinguishing APL from non-APL AML than either of these antigens alone. It was found that cCD79a and CD19 were the most sensitive marker for B-ALL while cCD3, CD7 and CD5 were the most sensitive antigens for T-ALL. Our analysis of AL phenotypes proved that employed antibody panels are adequate for proper diagnosis and classification of AL. Flowcytometry was found to be especially useful in the identification of AML-M0 and differentiation of APL from non-APL AML. Immunophenotyping results and FAB classification of our AL patients were comparable to internationally published studies apart from predominance of AML-M4/5 and more frequent APL.

Flow Cytometric Diagnosis of Acute Leukemia and Aberrant Antigen: Sohag University Experience

“…This high percentage of AML may be due to the high percentage of adult patients, adult to child ratio was (2.8:1), and 47% of ALL patients were children. These data were in agreement with the most of previous studies in Egypt [4], which reported 68.9% and 31.1% AML and ALL, respectively, and a Jordan study, in which percentages of AML and ALL were (52%) and (47%) respectively [7]. Regarding the FAB classification of acute myeloid leukemia M2 subtype was the most frequent (31.8%) followed by M4 -M5 subtypes (27.3%) and this is matched with results of many studies in Egypt [8] [9].…”

“…The most frequently lymphoid antigen aberrantly expressed in AML was CD7 (25%), followed by CD19 (13.4%) then CD22 (9.1%).This in accordance with most of studies based on assessments of aberrant markers in AML which show similar frequency of CD7 positivity in AML [4] [25] [26]. In contrast with our observation El-Sissy et al observed that CD7 was expressed in a minority of patients with AML 4/34 (11.8%) [20], and Shen et al reported CD7 expression in 28/222 (12.6%) [27].…”

“…Regarding the FAB classification of acute myeloid leukemia M2 subtype was the most frequent (31.8%) followed by M4 -M5 subtypes (27.3%) and this is matched with results of many studies in Egypt [8] [9]. However, other national and international studies have reported that M4 -M5 subtypes are the most common [4] [10]. For ALL, B-ALL was more frequent than T-ALL (85.7%) & (14.3%) respectively which agreed with other studies [11] [12].…”

“…The majority of acute leukemia cases expresses specific lineage markers; however, aberrant immunophenotypes can be detected in a variable number of cases, and it is of clinical importance not only for the accurate diagnosis, but also it has been shown to be useful for providing prognostic information and in detection of minimal residual disease [2] [3]. Its ability to measure multiple parameters on individual cells in a suspension at high speed is ideal for the study of leukemic cells [4].…”

Importance of FISH combined with Morphology, Immunophenotype and Cytogenetic Analysis of Childhood/Adult Acute Lymphoblastic Leukemia in Omani Patients

“…The lineage of most cases of morphologically and cytochemically poorly differentiated ALL's can be accurately characterized by immuno¬phenotyping (Salem and Abd El-Aziz, 2012). Flow Cytometry was used to confirm the blast Immunophenotype using a TdT assay and a panel of monoclonal antibodies (Mo Abs) to T cell and B cell associated antigens were used to identify almost all cases of ALL (Jennings and Foon, 1997).…”