Flowcytometric Evaluation and Morphological and Cytochemical correlation of 150 cases of Acute Leukemia

Abstract

Background : Immunophenotyping by flowcytometry is well conceived & fundamental tool to diagnose & subtype hematological malignancy, especially acute leukemia. By detecting various antigens presenting in various parts of cell, it is possible to know cell lineage & immaturity of the cell or group of cells. Apart from diagnostic importance, this specialized tool is also useful in prediction of prognosis & detection of minimal residual disease. Now, immunophenotyping can diagnose and type also those acute leukemias where morphology and cytochemistry fail. Aim : Study of Immunophenotypic patterns and their correlation with morphology and cytochemistry in North Indian Population. Materials and methods : Short clinical details and complete blood count of 150 patients were noted in the department of hematology of tertiary health centre. Sample of each patient was processed as per protocol and run on FACS CALIBUR OF BD BIOSCIENCES, USA . Dot plot data of each patient was analyzed and result was released. Results: AML, B-ALL and T-ALL comprised 38%, 49%, and 13% of all cases. Almost all blasts were expressing dimCD45 with no significant differences between the subtypes. CD34 have different expressions in AML subtypes, usually negative in APML. Aberrant expression of CD7 and CD19 were expressed in 5% and 3.4%of all cases of AML respectively. In 40% cases, morphology and Cytochemical studies clinched the diagnosis. 60% cases essentially needed Flowcytometric evaluation for diagnosis and subtyping of acute leukemias. Conclusion: Flowcytometric analysis of the patterns and intensity of antigen expression in blasts improved the diagnosis of AML and ALL in our centre. All cases do not require Immunophenotyping for diagnosis. Simultaneous use of conventional morphology, cytochemistry and flowcytometry reduce diagnostic cost of acute leukemia. Immunophenotyping results of our acute leukemia patients were comparable to international published studies.