Applicability of a Single 5 Color Cytoplasmic Markers Tube as Primary Panel in Routine Immunophenotyping of Acute Leukemia

Abstract

Background: Immunophenotyping in acute leukemia is a routine practice for lineage assignment. Conventionally a primary panel with surface markers are applied first followed by cytoplasmic markers as secondary panel in the diagnosis of acute leukemia.We in this present study aim to assess the relevance of a single 5 color “CD45, MPO, CD79a, CD3, Tdt” cytoplasmic markers combination to be utilized as primary panel. Methods: Sensitivity and specificity of different subset of positive negative combination of these markers were retrospectively analyzed in the 458 acute leukemia cases. Results: MPO or cCD3 positivity alongwith cCD79a negativity was 100% specific diagnosis for AML and T-ALL respectively. Furthermore, cCD79a positivity along with MPO and cCD3 negativity was 97.2% specific for B-ALL diagnosis. MPO and cCD79a dual positivity was found 100% sensitive and 92.6% specific for MPAL (B-My) diagnosis. MPO and cCD3 dual positivity was 100% sensitive and specific for MPAL (T-My) diagnosis. Conclusion: We found a good correlation of this single tube diagnosis when compared with standard morphology, cytochemistry, and flow cytometry based diagnosis. We hope our this cytoplasmic panel may help to design a precise extended immunophenotypic panel for acute leukemia diagnosis and may also be a cost effective approach in resource constrained developing countries.