Background: Acute leukaemia is defined as the presence of
over 20% of blasts cells in the blood or bone marrow. Acute myeloid leukaemia
(AML) and acute lymphoblastic leukaemia (ALL) are the 2 main types. Acute
myeloid leukaemia is a cancer of the myeloid lineage of blood cells and it is
the commonest form of acute leukaemia in adults with a median age of 65 years.
AMLs have characteristic morphological findings and molecular features with
different surface and cytoplasmic cluster of differentiation (CD) markers.
These CD markers are determined by immunophenotyping/flow cytometry on
leukocytes which helps with accurate diagnosis and reproducibility of AMLs.
Flow cytometry plays an important role in the diagnosis, sub classification and
monitoring of patients with AML. AML generally shows aberrant CD expression or
co- expression in relation to normal myeloid cells.
Objective of the Study: Objective of the Study was to
evaluate the frequency and the pattern of aberrant CD expression in AML
patients referred to a tertiary care hospital in Sri Lanka in comparison to
other published data. There was no comparative data available in respect of Sri
Lanka.
Materials and Methods: A retrospective descriptive study
including 26 cases of AML diagnosed over a period of 12 months were analyzed.
Diagnosis of AML was made by morphology of peripheral blood, bone marrow,
trephine biopsies, Sudan Black B stain and the immunophenotypic analysis by
multiparameter flow cytometry on bone marrow aspirates or peripheral blood. The
markers used in flow cytometry were CD 45, CD34, CD19, CD7, smCD3, cyCD3,
cyMPO, cyCD79a, CD20, CD15, CD10, CD5, HLADR, CD64, CD13, CD117, CD33, and
CD14. The identification of blasts cells was performed using forward scatter
(FSC) versus side scatter (SSC) parameters and CD45 intensity versus SSC dot
plots.
Results: Diagnosed AMLs were morphologically classified
according to the French-American-British (FAB) Classification (FAB Subtypes).
Among the 26 AML patients, 15 cases (57.69%) had the conventional CD antigen
expressions of myeloid lineage. Other 11 cases (42.3%) were AML with aberrant
expression of CD markers. Aberrancies of cyCD3 and CD7 were observed in 54.5%
and 45.4% AML cases, respectively. smCD3 in 1 case out of 11 aberrant AML
cases. Co expression of T lymphoid markers with myeloid markers occurred in 23%
cases in our study. CD13 was not expressed in 1 case out of 5 AML- M4 cases and
1 case out of 7 AML- M1. CD33 was not expressed in 1 case out of 2 AML -M0
cases.
Conclusion: We conclude that aberrant expression of CD
markers is seen in a significant population of AMLs. cyCD 3, CD7 and smCD 3
were the aberrant markers present in our study population with cyCD3 showing
highest frequency.
Author(s) Details
Dr. (Ms). C. C. Kariyawasan (MBBS, Diploma in Pathology, MD in Haematology)
Department of Hematology, Sri Jayewardenepura General
Hospital, Sri Lanka
B. L. T. Balasuriya (B.Sc in Medical Laboratory Sciences
(Special), M.Phil. (Haematology-reading)
Department of Hematology, Sri Jayewardenepura General
Hospital, Sri Lanka.
S. A. C. D. Ranatunga (B.Sc in Medical Laboratory
Sciences (Special), M.Sc in Molecular Pathology)
Department of Hematology, Sri Jayewardenepura General
Hospital, Sri Lanka.
Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v1/984
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