Diagnostic Utility of Immunophenotyping by Flow Cytometry for Diagnosis and Classification of Acute Leukemias in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Background: Immunophenotypic characterization of acute leukemia is an important clinical application of flow cytometry and has become a powerful tool contributing to proper diagnosis and classification. The aim of this study is to phenotype and classify acute leukemias by flow cytometry using commonly used markers for leukemia diagnosis.
Methods: A total of 40 pediatric and adult patients diagnosed with acute leukemia were evaluated by flow cytometry with 17 surface and cytoplasmic markers known to be useful in discriminating different types of acute leukemia. These results were compared with classification results using standard morphological criteria.
Results: 21 of 40 patients (52.5%) were classified as acute myeloblastic leukemia (AML) while 19 (47.5%) were identified as acute lymphoblastic leukemia (ALL). Of all the ALL cases, 10 of the 19 (52.6%) were B-ALL and 47.4% (9/19) were T-ALL based on flow cytometry. Markers of immaturity HLA-DR and CD34 antigens were co-expressed in 61% of AML cases and 33% of T-ALL cases, whereas CD34 was expressed in 50% of the B-ALL cases. cMPO and CD13 were the most expressed markers of AML, CD19 and cCD79a were present in all cases of B-ALL, and cytoplasmic CD3 and CD7 were positive on most all T-ALL cases. Discrimination of AML from ALL patients by flow cytometry was 80% concordant with traditional morphology. Notable discrepancies occurred in cases where leukemia cells expressed markers for more than one lineage.
Conclusions: In the Ethiopia setting, flow cytometry represents a feasible and promising adjunctive diagnostic approach for acute leukemia.
Del Vecchio L, Brando B, Lanza F, et al. Recommended reporting format for flow cytometry diagnosis of acute leukemia. Haematologica. 2004;89(5):594-8.
Rowan R, Bain BJ, England JM, et al. Immunophenotyping in the diagnosis of acute leukemias. J Clin Pathol. 1994;47:777-81.
Wozniak J, Kopec-Szlezak J. Standard immunophenotyping of leukemia cells in acute myeloid leukemia (AML). Centr Eur J Immunol. 2008;33(1):24-32.
Shamebo M. Acute leukaemias in adult Ethiopians in a teaching hospital. Ethiop Med J. 1994;32(1):17-25.
Shamebo M. Leukaemia in adult Ethiopians. Ethiop Med J. 1990;28(1):31-7.
Mhawech P, Buffone GJ, Khan SP, Gresik MV. Cytochemical staining and flow cytometry methods applied to the diagnosis of acute leukemia in the pediatric population: an assessment of relative usefulness. J Pediatr Hematol Oncol. 2001;23(2):89-92.
Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med. 2005;37(5):360-3.
Ortolani C. Flow cytometry of hematological malignancies. 1st ed. Chicester, West Sussex, UK: Willey-Blackwell Publishing; 2011.
Garand R, Robillard N. Immunophenotypic characterization of acute leukemias and chronic lymphoproliferative disorders: practical recommendations and classifications. Hematol Cell Ther. 1996;38(6):471-86.
Van Dongen J, Macintyre E, Gabert J, et al. Standardized RT-PCR analysis of fusion gene transcripts from chromosome aberrations in acute leukemia for detection of minimal residual disease Report of the BIOMED-I Concerted Action: Investigation of minimal residual disease in acute leukemia. Leukemia. 1999;13:1901-28.
Salem DA, El-Aziz SMA. Flowcytometric immunophenotypic profile of acute leukemia: mansoura experience. Indian J Hematol Blood Transfus. 2012;28(2):89-96.
Paredes‐Aguilera R, Romero‐Guzman L, Lopez‐Santiago N, et al. Flow cytometric analysis of cell‐surface and intracellular antigens in the diagnosis of acute leukemia. Am J Hematol. 2001;68(2):69-74.
Peters JM, Ansari MQ. Multiparameter flow cytometry in the diagnosis and management of acute leukemia. Arch Pathol Lab Med. 2011;135(1):44-54.
Kaleem Z, Crawford E, Pathan MH, Jasper L, Covinsky MA, Johnson LR, et al. Flow cytometric analysis of acute leukemias: diagnostic utility and critical analysis of data. Arc Pathol Lab Med. 2003;127(1):42-8.
Patel K, Lotodo T, Njuguna F, et al. Use of flow cytometry immunophenotyping for diagnosis of acute leukemia at Moi Teaching and Referral Hospital, Eldoret, Kenya. American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS). 2015;13(1):72-80.
Belurkar S, Mantravadi H, Manohar C, Kurien A. Correlation of morphologic and cytochemical diagnosis with flowcytometric analysis in acute leukemia. J Cancer Res Ther. 2013;9(1):71-9.
Khalil S, Jackson J, Pyle R, Robichaud M. Immunophenotyping of acute leukemia at King Faisal Specialist Hospital and Research Centre. Ann Saudi Med. 1995;15(2):137-9.
Article MetricsAbstract view : 95 times
PDF - 44 times
- There are currently no refbacks.
Copyright (c) 2021 Indonesian Journal of Cancer
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.