Flow cytometric assessment of CD30 expression in adult patients with acute leukemia

Abstract

Background CD30, a member of tumor necrosis factor receptor superfamily, was originally identified as a cell-surface marker of Reed–Sternberg cell in classical Hodgkin lymphoma. CD30 is also expressed by several types of T-cell and B-cell non-Hodgkin’s lymphoma, such as anaplastic large cell lymphoma and primary mediastinal large B-cell lymphoma, and Epstein–Barr virus driven clonal lymphoproliferative disorder, as well as in reactive conditions such as infectious mononucleosis.Patients and methods A cross-sectional study was conducted at Clinical Hematology Department in Ain Shams University Hospital during a period from November 2016 to August 2017. A total of 20 new cases of acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) and 30 refractory/relapsed cases of AML and ALL either T or B, were enrolled in this study. CD30% expression was assessed by flow cytometry on bone marrow sample or peripheral blood.Results CD30 with cutoff more than 20% (+ve) was seen in 46% of cases, whereas cases with cutoff less than 20% (−ve) represented 54% of all leukemia cases. CD30 expression was higher in ALL, especially in T–acute lymphocyctic leukemia (T-ALL), with mean value of 44.564±27.158, with significant increase relapsed T-ALL (P=0.031) followed by B-ALL (23.988±15.678). CD30 expression in relapsed AML and ALL showed an increased percent but not yet statistically significant. Significant correlation was found in risk parameters as in white blood cells (WBCs) (>100 000) as well as Platlets (PLT) (<30 000) and CD30 expression in patients with T-ALL, with P values of 0.038 and 0.021, respectively, and nonsignificant difference between lactate dehydrogenase (LDH) and minimal residual disease in T-ALL and all risk parameters in B-ALL. Receiver operator characteristic (ROC) curve revealed that the accuracy of sensitivity and specificity was 69.9%.Conclusion CD30 has been shown to be a significant diagnostic tool in cases of acute leukemia especially in newly and relapsed T-ALL; moreover, it can be labeled to be a targeted therapy. Drug trials using monoclonal antibodies to CD30 as treatment in relapsed/refractory cases with special concern to response and survival rate are needed.