A Flow-Cytometric Analysis of Spectrum of Acute Myeloid Leukemia at Diagnosis

Authors

  • Parineetha V Shetty Department of Pathology, AJ Institute of Medical Sciences and Research Center, Mangalore
  • Sandhya I Department of Pathology, AJ Institute of Medical Sciences and Research Center, Mangalore
  • Ishant Anand Department of Pathology, AJ Institute of Medical Sciences and Research Center, Mangalore
  • Prithal G Department of Pathology, AJ Institute of Medical Sciences and Research Center, Mangalore
  • Purnima Rao Department of Pathology, AJ Institute of Medical Sciences and Research Center, Mangalore
  • Rachan Shetty Consultant Oncologist, AJ Institute of Medical Sciences and Research Center, Mangalore

DOI:

https://doi.org/10.21276/apalm.2913

Keywords:

Acute Myeloid Leukemia, Acute Promyelocytic Leukemia

Abstract

Background: Acute Myeloid Lymphoma is the clonal proliferation of non-lymphoid blasts comprising at least 20% of total nucleated cells either in bone marrow or peripheral blood. In the recent years, flow cytometry has emerged as a powerful diagnostic tool for AML due to its impact on treatment and prognosis.

Aims & Objectives:

  1. To analyse the flow cytometry findings in patients diagnosed as acute myeloid leukemias.
  2. To evaluate variations in flow cytometry expression in various subtypes of acute myeloid leukemia

Materials & Methods: Patients diagnosed as acute myeloid leukaemia on peripheral smears were subjected to flow cytometry analysis. This was a four-year study from July 2015 to June 2017 retrospectively and from July 2017 to June 2019 prospectively.

Results: A total of 27 cases diagnosed as Acute Myeloid Leukemia (AML) were included in the study. Acute Promyelocytic Leukemia was observed to be the most common subtype. The most commonly expressed myeloid antigens were CD13 and CD33. There was an aberrant expression of CD7 and CD56 in 1 case each indicating adverse prognosis.

Conclusion: Immunophenotyping of the myeloid cells by flow cytometry has revolutionised the diagnosis of acute myeloid leukemias. It aids in confirming the morphological diagnosis, and also helps in assigning specific lineage, accurate sub classification and adequate treatment in challenging cases. Aberrant expressions were observed in 3 cases of AML. Aberrant antigen expression is associated with a poor outcome.  Flow cytometry results interpreted with morphology are not only complementary but also conclusive aiding in therapeutics and predicting prognosis.

References

Narang V, Dhiman A, Garg B, Sood N, Kaur H. Immunophenotyping in Acute leukemias: First tertiary care centre experience from Punjab. Indian Journal of Pathology and Oncology, April-June 2017; 4(2):297-300.

Arber DA. Principles of Classification of Myeloid Neoplasms In: Jaffe ES, Arber DA, Campos E, Harris NL, Quintanilla-Martinez L (eds.) Hematopathology. 2nd edition. Philadelphia: Elseveir; 2017. p.785

Freud AG, Arber DA. Acute myeloid leukemia In: Orazi A, Foucar K, Knowles DM, Weiss LM (eds.) Knowles’ Neoplastic Hematopathology. 3rd edition. Philadelphia: Wolters Kluver; 2014. p.1030

Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, Bloomfield CD, Cazzola M, Vardiman JW. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016 May 19;127(20):2391-405.

Peters JM, Ansari MQ. Multiparameter flow cytometry in the diagnosis and management of acute leukemia. Arch Pathol Lab Med 2011; 134:44-54.

Gupta A, Pal A, Nelson SS. Immunophenotyping in Acute Leukemia: A Clinical Study. Int J Sci Stud 2015; 3(5):129-136.

Elorza I, Palacio C, Dapena JL, Gallur L, Sanchez de Toledo J, and Diaz de Heredia C. Relationship between minimal residual disease measured by multiparametric flow cytometry prior to allogeneic hematopoietic stem cell transplantation and outcome in children with acute lymphoblastic leukemia. Haematologica 2010; 95:936-941.

Alegretti AP, Bittar M C, Bittencourt R, Piccoli AK, Schneider L, Silla LM et al. The expression of CD56 antigen is associated with poor prognosis in patients with acute myeloid leukemia. Rev Bras Hematol Hemoter 2011; 33(3):202-6.

Horner MJ, Krapcho M. SEER C(JllceT JltatUfica review. 1975-2006, acute myeloid leukemia section. Bethesda: National Cancer Institute, 2009.

Singh T. Acute leukemias. Atlas and text of hematology. Vol 1. 4th edition. Delhi: Avichal Publication Company; 2018. p. 237-314.

Poeta GD, Stasi R, Venditti A, Cox C, Aronica G, Masi M et al. CD7 expression in acute myeloid leukemia. Leukemia and Lymphoma 1995; 17: 111-119.

Arber DA, Brunning RD, Orazi A, Porwit A, Peterson LC, Thiele J. Acute myeloid leukaemia, NOS In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H et al (eds). WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th edition. Lyon, France: IARC Press; 2017. p. 156-166.

Ghosh S, Shinde SC, Kumaran GS, Sapre RS, Dhond SR, Badrinath Y et al. Hematologic and immunophenotypic profile of acute myeloid leukemia: an experience of Tata Memorial Hospital. Indian J Cancer 2003; 40: 71.

Chang H, Brandwein J, Yi QL, Chun K, Patterson B, Brien B. Extramedullary infiltrates of AML are associated with CD56 expression, 11q23 abnormalities and inferior clinical outcome. Leuk Res 2004; 28(10): 1007-11.

Lee J J, Cho D, Chung IJ, Cho SH, Park KS, Park M R et al. CD34 Expression Is Associated With Poor Clinical Outcome in Patients With Acute Promyelocytic Leukemia.

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Published

30-01-2021

How to Cite

1.
Shetty PV, I S, Anand I, G P, Rao P, Shetty R. A Flow-Cytometric Analysis of Spectrum of Acute Myeloid Leukemia at Diagnosis. Ann of Pathol and Lab Med [Internet]. 2021 Jan. 30 [cited 2024 Nov. 19];8(1):A20-25. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/2913

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