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Strullu M, Caye-Eude A, Robert E, Renard JM, Chaye A, Galimand J, Fenneteau O, Arfeuille C, Cuccuini W, Theron A, Thouvenin S, Paillard C, Petit A, Rohrlich PS, Cavé H, Baruchel A, Lainey E. CD36 cell surface expression as a surrogate marker to identify ABL/JAK-class kinase fusions in pediatric BCP-ALL. Leukemia 2024:10.1038/s41375-024-02421-5. [PMID: 39420220 DOI: 10.1038/s41375-024-02421-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 08/23/2024] [Accepted: 09/20/2024] [Indexed: 10/19/2024]
Abstract
Genetic alterations are the cornerstone of risk stratification in B-cell precursor acute lymphoblastic leukemia (BCP-ALL), and their accurate identification is critical for optimal treatment. Most cases with ABL-class fusion are classified as high-risk yet display good responses to tyrosine kinase inhibitors (TKIs). Current clinical protocols recommend adding a TKI to chemotherapy as soon as possible, making it mandatory to rapidly identify these alterations. We investigated here whether the identification of immunophenotypic features associated with these molecular alterations could be a valuable screening tool. CD36 expression was shown to be a characteristic feature of ABL- or JAK-class kinase fusions. The main genetic subgroups clustering in the subset with Philadelphia (Ph)-like features were also found to display specific immunophenotypic characteristics. A predictive multiparameter scoring system was generated, segregating genetic subtypes with aberrant kinase activation (PAX5/CRLF2alt, BCR::ABL1, ABL/JAK-class). The most robust markers identified were the TSLPR with CD19/22/9/38/81/304 and CD49f. As TKI adjunction is currently limited to the ABL-class kinase fusions, immunophenotypes distinguishing ABL from JAK-class were also investigated. The flow cytometry method reported here, accessible to most hematology departments, is thus a new useful tool to quickly screen for Ph-like kinase fusion with a good sensitivity (95%) and specificity (96%).
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Affiliation(s)
- Marion Strullu
- Pediatric Hematology and Immunology Department, Robert-Debré Hospital (Assistance Publique-Hôpitaux de Paris (APHP)), Paris, France
- University of Paris Cité, Paris, France
- INSERM U1131, IUH, Paris, France
| | | | - Elie Robert
- INSERM U1170, Gustave Roussy Cancer Campus, Université Paris Saclay, PEDIAC Program, Villejuif, France
| | | | - Amandine Chaye
- Hematology Laboratory, Robert-Debré Hospital, APHP, Paris, France
| | - Julie Galimand
- Genetic Department, Armand Trousseau, APHP, Paris, France
| | - Odile Fenneteau
- Hematology Laboratory, Robert-Debré Hospital, APHP, Paris, France
| | - Chloé Arfeuille
- INSERM U1131, IUH, Paris, France
- Genetic Department, Robert-Debré Hospital, APHP, Paris, France
| | - Wendy Cuccuini
- Hematology Laboratory, Saint-Louis Hospital, APHP, Paris, France
| | - Alexandre Theron
- Department of Pediatric Oncology and Hematology, CHU Montpellier, Montpellier, France
| | - Sandrine Thouvenin
- Department of Pediatric Onco-hematology, CHU de Saint-Etienne, Saint-Etienne, France
| | - Catherine Paillard
- Department of Pediatric Hematology-Oncology, CHU de Strasbourg, Strasbourg, France
| | - Arnaud Petit
- Department of Pediatric Onco-hematology, Sorbonne University, Armand Trousseau Hospital, APHP, Paris, France
| | - Pierre-Simon Rohrlich
- Pediatric Hematology-Oncology Department, CHU de Nice, Université de Côte d'Azur, Nice, France
| | - Hélène Cavé
- University of Paris Cité, Paris, France
- INSERM U1131, IUH, Paris, France
- Genetic Department, Robert-Debré Hospital, APHP, Paris, France
| | - André Baruchel
- Pediatric Hematology and Immunology Department, Robert-Debré Hospital (Assistance Publique-Hôpitaux de Paris (APHP)), Paris, France
- University of Paris Cité, Paris, France
- URP-3518, Institut de Recherche Saint-Louis, Paris, France
| | - Elodie Lainey
- University of Paris Cité, Paris, France.
- INSERM U1131, IUH, Paris, France.
- Hematology Laboratory, Robert-Debré Hospital, APHP, Paris, France.
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Yadav V, Raveendranath V, Ganesan P, Kar R, R P, Manivannan P. Immunophenotypic Characteristics and Cytogenetic Analysis of Adolescent and Young Adult B-Cell Acute Lymphoblastic Leukemia: Correlations With Clinicopathological Parameters. Cureus 2024; 16:e68735. [PMID: 39371707 PMCID: PMC11454831 DOI: 10.7759/cureus.68735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2024] [Indexed: 10/08/2024] Open
Abstract
Introduction Acute lymphoblastic leukemia (ALL) has suboptimal survival rates for adolescents and young adults (AYA) as compared to children. Very limited studies have been conducted on AYA patients in India. This study aimed to identify the cytogenetic and immunophenotype characteristics of B-cell ALL (B-ALL) in AYA patients and determine its correlation with clinicopathological parameters in the Southern India region. Method The study was a prospective study conducted for three years, from June 2019 to May 2022, in India. Newly diagnosed 90 patients with AYA (13-40 years) ALL were recruited. A B-ALL diagnosis was made based on morphology with cytochemical stains and immunophenotype by flow cytometry (FCM). Cytogenetic analysis was also performed using karyotyping and fluorescent in situ hybridization to identify chromosomal aberrations. The cytogenetics results were correlated with immunophenotyping and clinicopathological characteristics. Variables were analyzed using the Mann-Whitney U test and Chi-square test using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, NY, USA). Results The mean age was 22.68 ± 8.06 years. It was observed that the most common structural chromosomal abnormality for AYA was t(9;22) in 14 (15%) cases, followed by 6q deletions in seven (8%) cases, t(1;19) in four (4%) cases, and t(12;17) and t(6;14) in two (2%) cases each. In addition, t(3;12), t(2;11), t(12;21), t(1;9), t(2;12), and t(X;10) were found in one (1%) case each. The most common numerical abnormality was hyperdiploidy (15; 17%), followed by hypodiploidy (10; 11%). Further, myeloid antigen expression of CD33 was the most common aberrantly expressed marker found in 20 (28%) cases, followed by CD15 in three cases (5%), CD13 in three (4%) cases, and CD11b in two (3%) cases. It was also observed that in Ph+ve cases, CD33 and CD13 were most commonly expressed in three (33%) and two (17%) cases, respectively. In contrast, in Ph-ve patients, their expressions were lesser at 17 (27%) and one (2%) cases, respectively. In addition, leukemia-associated immunophenotype pattern (LAIP) markers CD44 6 (86%) and CD123 5 (55%) were also found to be significantly associated with Ph+ve, whereas their values in the Ph-ve group were lesser at 25 (42%) and 9 (17%), respectively. Our data also showed that older age wassignificantly associated with Ph+ve with a median age of 30 years (p = 0.012). In comparison, the median age of Ph-ve was only 21 years. Conclusion Our study established that the incidence of cytogenetic abnormalities for AYA was consistent with previously reported data. This study reaffirms that Ph+ve cases have significant associations with MyAg (CD13), LAIP (CD123 and CD44), and older age for the South Indian population.
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Affiliation(s)
- Vineeta Yadav
- Anatomy, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, IND
| | | | - Prasanth Ganesan
- Oncology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, IND
| | - Rakhee Kar
- Pathology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, IND
| | - Priyadharshini R
- Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, IND
| | - Prabhu Manivannan
- Pathology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, IND
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Wang HY, Louis HMS, Costello CL, Murray SS, Dell'Aquila ML. A CD10-negative adult B-lymphoblastic leukaemia with amplification of KMT2A without rearrangement: A case report and review of the English literature. Br J Haematol 2024; 205:364-367. [PMID: 38735761 DOI: 10.1111/bjh.19520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/27/2024] [Indexed: 05/14/2024]
Affiliation(s)
- Huan-You Wang
- Division of Laboratory and Genomic Medicine, Department of Pathology, University of California San Diego Health Sciences, La Jolla, California, USA
| | - Hailee M St Louis
- Division of Laboratory and Genomic Medicine, Department of Pathology, University of California San Diego Health Sciences, La Jolla, California, USA
| | - Caitlin L Costello
- Division of Blood and Marrow Transplant, Department of Medicine, University of California San Diego Health Sciences, La Jolla, California, USA
| | - Sarah S Murray
- Division of Laboratory and Genomic Medicine, Department of Pathology, University of California San Diego Health Sciences, La Jolla, California, USA
| | - Marie L Dell'Aquila
- Division of Laboratory and Genomic Medicine, Department of Pathology, University of California San Diego Health Sciences, La Jolla, California, USA
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Cunningham MT, Winters C, Farrell D. Burkitt Lymphoma With Aberrant Expression of Cytoplasmic Terminal Deoxynucleotidyl Transferase: A Case Report. Cureus 2024; 16:e53972. [PMID: 38348200 PMCID: PMC10859684 DOI: 10.7759/cureus.53972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2024] [Indexed: 02/15/2024] Open
Abstract
This study describes a rare case of Burkitt lymphoma with aberrant expression of cytoplasmic terminal deoxynucleotidyl transferase (TdT). Flow cytometry demonstrated a predominantly mature B cell immunophenotype as expected for Burkitt lymphoma, however, the immature marker TdT was also expressed. Immunohistochemistry showed that TdT was localized to the cytoplasm, with absent nuclear localization. The patient received standard intensive chemotherapy for Burkitt lymphoma and has remained in remission for nine years. Pathologists should be aware of this unusual phenomenon of aberrant cytoplasmic TdT expression to avoid confusing Burkitt lymphoma with B cell lymphoblastic leukemia/lymphoma.
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Affiliation(s)
- Mark T Cunningham
- Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, USA
| | | | - Daniel Farrell
- Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, USA
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Gupta DG, Varma N, Sharma P, Truica MI, Abdulkadir SA, Singh P, Singh Sachdeva MU, Naseem S, Siddiqui MR, Bose P, Binota J, Malhotra P, Khadwal A, Trehan A, Varma S. Hematological, clinical, immunophenotypic characterization, and treatment outcomes of prognostically significant genetic subtypes of B-lineage acute lymphoblastic leukemia: A report of 1021 patients from India. Cancer 2023; 129:3390-3404. [PMID: 37498973 DOI: 10.1002/cncr.34957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND The published literature on hematological, clinical, flowcytometric-immunophenotyping, and minimal residual disease outcomes of the prognostically important genetic subtypes of acute lymphoblastic leukemia (ALL) is scarce from low-income countries. For newer classifications such as BCR::ABL1-like ALLs, the scarcity of patient-level data is even more pronounced. METHODS The authors performed comprehensive detection of recurrent gene fusions and BCR::ABL1-like ALL cases followed by immunophenotypic profiling and obtained clinical outcome parameters for a large cohort (n = 1021) of patients from India. This cohort included a significant number of patients with BCR::ABL1-like ALL subtype and other genetic subtypes of ALL. RESULTS Patients with BCR::ABL1-positive and BCR::ABL1-like ALL were significantly older, had male preponderance, and expressed a higher white blood cell count than BCR::ABL1-negative cases (p < .05). Logistic regression modeling of B-lineage-ALL (B-ALL) subtypes revealed that cluster of differentiation (CD)36 is a strong statistically significant predictive marker of BCR::ABL1-like ALL (p < .05). Furthermore, patients with BCR::ABL1-like ALLs show a significantly higher frequency of CD36 expression compared to BCR::ABL1-negative ALLs (p < .05). In terms of clinical symptoms, lymphadenopathy is a strong statistically significant predictive marker in BCR::ABL1-like ALLs compared to BCR::ABL1-negative ALL cases (p < .05). In terms of treatment outcomes, minimal residual disease (MRD) positivity in BCR::ABL1-positive ALL cases were statistically significant (p < .05), and BCR::ABL1-like ALL cases had high MRD-positivity as compared to BCR::ABL1-negative ALL cases but did not show statistical significance. CONCLUSIONS The findings evince the use of novel therapies and personalized treatment regimens to improve the overall survival of the newer incorporated entities in B-ALLs. This is the first report characterizing the hematological, clinical, flowcytometric-immunophenotyping, and minimal residual disease outcomes of the prognostically significant subtypes of ALLs in patients from India. PLAIN LANGUAGE SUMMARY Characterizing the hematological, clinical, flowcytometric-immunophenotyping, and minimal residual disease outcomes of the prognostically significant subtypes (n = 1021) of acute lymphoblastic leukemia (ALLs) in patients from India. We have made two independent logistic regression models of cluster of differentiation (CD) markers and clinical symptoms to differentiate prognostically significant subtypes of ALLs. Logistic regression analysis of CD markers revealed CD36 as a strong predictor in BCR::ABL1-like ALL cases compared to BCR::ABL1-negative ALL cases. Logistic regression analysis of clinical symptoms revealed lymphadenopathy significantly predicts BCR::ABL1-like ALLs (p < .05). In terms of treatment outcomes, BCR::ABL1-positive ALL had statistically significant minimal residual disease (MRD) (p < .05), and BCR::ABL1-like ALL cases had high MRD-positivity but did not show statistical significance as compared to BCR::ABL1-negative ALLs.
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Affiliation(s)
- Dikshat Gopal Gupta
- Department of Urology and Pathology, The Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Neelam Varma
- Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Praveen Sharma
- Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mihai I Truica
- Department of Urology and Pathology, The Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sarki A Abdulkadir
- Department of Urology and Pathology, The Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Parmod Singh
- Department of Anatomy, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Man Updesh Singh Sachdeva
- Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shano Naseem
- Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mohammad Rizwan Siddiqui
- Department of Pediatrics, Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Parveen Bose
- Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jogeshwar Binota
- Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Malhotra
- Department of Clinical Hematology and Medical Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Alka Khadwal
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Amita Trehan
- Pediatric Hematology Oncology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Subhash Varma
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Venugopalan RK, Singh N, Anthony ML, Kunnumbrath A, Gupta AK, Nath UK, Chowdhury N, Chandra H. Leukemia-associated aberrant immunophenotype: A flow cytometry-based experience of 110 cases from a tertiary care center in Northern India. J Cancer Res Ther 2023; 19:1335-1339. [PMID: 37787304 DOI: 10.4103/jcrt.jcrt_809_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Background Leukemic cells express a characteristic set of "cluster of differentiation" (CD) markers, which forms the basis of the current WHO classification. Leukemia-associated aberrant immunophenotype (LAIP) refers to expression of unusual CD markers by leukemic cells, which are not normally expressed by their respective lineage. The incidence of LAIP varies considerably, and its clinical implications, prognostic relevance, and sensitivity to therapy are still debatable. This study was conducted to identify the immunophenotypic aberrancies in newly diagnosed leukemias in our Institute. Method This was an observational study, which included newly diagnosed leukemias on flow cytometry. Aberrant immunophenotypic expressions were recorded whenever present and were correlated with prognostic factors like age, gender, and total leucocyte count (TLC). Results The study included 110 newly diagnosed cases of leukemias (85 acute and 25 chronic) over 1.5 years. Immunophenotypic aberrancies were detected in 40.4% of the cases. The highest incidence of aberrations was detected in acute myeloid leukemia (60.7%). LAIPs were detected in 50% of T-acute lymphoblastic leukemia and 25% cases of in B-cell acute lymphoblastic leukemia (B-ALL). Aberrant CD33 and CD56 expression in B-ALL correlated with poor prognostic factors like higher age and higher TLC, respectively. Immunophenotypic aberrancies were present in 28% cases of chronic lymphocytic leukemia. Conclusion The results of this study have generated valuable baseline data on the incidence of LAIPs in this region. This information is vital because establishing LAIPs at the time of diagnosis is crucial for disease monitoring. Some LAIPs are associated with underlying cytogenetic abnormalities and hence impact the management and prognosis.
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Affiliation(s)
- Radhika K Venugopalan
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Neha Singh
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Michael L Anthony
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Arathi Kunnumbrath
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Arvind K Gupta
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Uttam K Nath
- Department of Medical Oncology and Hematology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Nilotpal Chowdhury
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Harish Chandra
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Al-Badran I, Al-Rubaie H, Al-Assadi T. Childhood acute lymphoblastic leukemia: Immunophenotypic profile and aberrant expression of CD13, CD33, CD117, CD11b, CD16, and CD64. IRAQI JOURNAL OF HEMATOLOGY 2022. [DOI: 10.4103/ijh.ijh_36_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Multicolor flow cytometry immunophenotyping and characterization of aneuploidy in pediatric B-cell precursor acute lymphoblastic leukemia. Cent Eur J Immunol 2021; 46:365-374. [PMID: 34764809 PMCID: PMC8574114 DOI: 10.5114/ceji.2021.109794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 05/31/2021] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to assess the incidence of DNA aneuploidy in Polish children with B-cell precursor acute lymphoblastic leukemia (BCP-ALL) and the relationship between aneuploidy and immunological phenotype, age, leukocyte count, S-phase fraction (SPF) and early response to induction chemotherapy assessed by the percentage of residual blast cells in bone marrow aspirates. The study group consisted of 267 patients. DNA content and immunophenotype were assessed in the bone marrow before treatment using multicolor flow cytometry (FC). DNA aneuploidy was detected in 50/267 (19%) patients. High hyperdiploidy was found to be associated with lower leukocyte count (p = 0.006) and common ALL immunophenotype. Flow cytometry analysis revealed that high hyperdiploid BCP-ALL patients showed significantly higher expression of CD9, CD20, CD22, CD58, CD66c, CD86 and CD123 antigens as compared to other groups of ploidy. In contrast, CD45 showed decreased expression. The percentage of leukemic blasts at diagnosis was lower in high hyperdiploid BCP-ALL cases than in diploid (79% vs. 85.7%, p = 0.001). The difference in minimal residual disease (MRD) levels on day 15 and 33 of induction therapy between analyzed groups was not significant. This study showed that high hyperdiploidy is associated with lower WBC count and specific immunological phenotype. Flow cytometric evaluation of expression of selected antigens can be used for fast identification of markers of aneuploidy in pediatric BCP-ALL, before genetic tests results are available. Understanding the biological significance of aneuploidy in leukemia can potentially be exploited therapeutically using targeted therapies against specific blast cell subclones.
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Gupta DG, Varma N, Naseem S, Sachdeva MUS, Bose P, Binota J, Kumar A, Gupta M, Rana P, Sonam P, Malhotra P, Trehan A, Khadwal A, Varma S. Characterization of the immunophenotypic aberrancies with respect to common fusion transcripts in B-cell precursor acute lymphoblastic leukaemia - a report of 986 Indian patients. Turk J Haematol 2021; 39:1-12. [PMID: 34617433 PMCID: PMC8886275 DOI: 10.4274/tjh.galenos.2021.2021.0326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Based on the immunophenotype, acute lymphoblastic leukemia (ALL) can be categorized into B-cell or T-cell lineages. B-cell precursor ALL (BCP-ALL) cases show various genetic/molecular abnormalities, and varying frequencies of chimeric fusion transcripts in BCP-ALL cases are reported from different parts of the world. We studied the immunophenotypic aberrancy profiles of a large number of BCP-ALL cases with respect to various common chimeric fusion transcripts. Materials and Methods: Flow cytometric immunophenotyping and multiplex reverse-transcription polymerase chain reaction assays were performed for 986 BCP-ALL cases. Results: Among 986 BCP-ALL cases, the incidence of various fusion transcripts was 38.36% in adult cases and 20.68% in pediatric cases. Adult BCP-ALL patients with t(9;22)(BCR-ABL1) fusion transcripts and expression of aberrant myeloid markers were significantly older at presentation (p=0.0218) with male preponderance (p=0.0246) compared to those without aberrant myeloid expression. In pediatric patients with the t(12;21)(ETV6-RUNX1) chimeric fusion transcript, aberrant expression of CD13 was observed in 39.13%, CD33 in 36.95%, and CD117 in 8.69% of patients, respectively. Pediatric BCP-ALL patients with the ETV6-RUNX1 fusion transcript and expression of aberrant myeloid markers were not significantly different compared to those without with respect to demographic and clinical/hematological characteristics (p=0.5955). Aberrant myeloid markers were rarely or never expressed in pediatric and adult BCP-ALL patients with the t(4;11)(KTM2A-AF4) and t(1;19)(TCF3-PBX1) fusion transcripts. Conclusion: Aberrant myeloid markers were frequently expressed among BCP-ALL patients with the t(9;22)(BCR-ABL1) and t(12;21)(ETV6-RUNX1) fusion transcripts. However, BCP-ALL patients with the t(4;11)(KTM2A-AF4) and t(1;19)(TCF3-PBX1) fusion transcripts rarely or never expressed aberrant myeloid markers. Aberrant myeloid CD markers can be used in predicting chimeric fusion transcripts at baseline so as to plan appropriate tyrosine kinase inhibitor therapy in cases of BCP-ALL with specific chimeric fusion transcripts. This study has delineated the relationship of chimeric fusion transcripts with the aberrant expression of myeloid markers in a large cohort of BCP-ALL cases.
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Affiliation(s)
- Dikshat Gopal Gupta
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Neelam Varma
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shano Naseem
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Parveen Bose
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jogeshwar Binota
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashish Kumar
- International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India
| | - Minakshi Gupta
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Palak Rana
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Preeti Sonam
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Malhotra
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Amita Trehan
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Alka Khadwal
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Subhash Varma
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Ye MT, Zhu J, Luo DX, Wang Y, Chen Z, Yang Y, Tian C, Zhang Y, You MJ. B-Lymphoblastic Leukemia With Aberrant CD5 Expression. Am J Clin Pathol 2021; 156:586-595. [PMID: 33822875 DOI: 10.1093/ajcp/aqaa269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES B-acute lymphoblastic leukemia (B-ALL) is a neoplasm of precursor lymphoid cells committed to the B-lineage. Expression of CD5 is rare in B-ALL. METHODS We studied the clinicopathologic, immunophenotypic, and molecular genetic features of 10 cases of B-ALL with aberrant CD5 expression, and compared with CD5-B-ALL. RESULTS B-ALL with aberrant CD5 expression is rare and predominantly affects men. Patients with CD5+ B-ALL had shorter median overall survival (21 vs 45 months, P = .0003). Expression of CD5 imposed a challenge in the differential diagnoses between B-ALL and other CD5+ B-cell lymphomas with blastic morphology. Dim CD20 and CD45, lack of surface immunoglobulin, expression of CD34 and TdT, negative immunostain for cyclin D1, and absence of t(11;14)(q13;q32) support a diagnosis of B-ALL. CONCLUSIONS CD5 expression is rare in B-ALL and associated with poor clinical outcome. CD5+ B-ALL represents a distinct entity that needs to be considered in the differential diagnoses of CD5+ B-cell lymphoproliferative disorders.
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Affiliation(s)
- Matthew T Ye
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jia Zhu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - David X Luo
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yi Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, and Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Zehui Chen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, and Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Yaling Yang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chen Tian
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, and Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Yizhuo Zhang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, and Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - M James You
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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11
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Mao J, Xue L, Wang H, Zhu Y, Wang J, Zhao L. A New Treatment Strategy for Early T-Cell Precursor Acute Lymphoblastic Leukemia: A Case Report and Literature Review. Onco Targets Ther 2021; 14:3795-3802. [PMID: 34168464 PMCID: PMC8219029 DOI: 10.2147/ott.s312494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/03/2021] [Indexed: 01/08/2023] Open
Abstract
Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is an aggressive and extremely fatal subtype of T-cell acute lymphoblastic leukemia (T-ALL), characterized by the similar transcriptional and immunophenotypic profiles to those of early T-cell precursors and positive expressions of myeloid antigens. Besides, the gene expression profile in ETP-ALL is similar to that in myeloid malignancies. The clinical characteristics, treatments and prognoses of ETP-ALL are significantly heterogeneous. In the present study, we reported a 43-year-old female patient who lacked terminal deoxynucleotidyl transferase (TDT) expression in immunophenotype and displayed mutations of fms-like tyrosine kinase-internal tandem duplication (FLT3-ITD), paired-box domain 5 (PAX5) and SH2B adaptor protein 3 (SH2B3) (PAX5 and SH2B3, the genes critical to B cell identity and function), which represent myeloid and precursor B-lineage associated gene mutations, respectively. It was a rare T-ALL or T-lineage case. Because of multiple poor prognostic factors in this case, conventional induction regimens, like hyper-CVAD (cyclophosphamide, vincristine, doxorubicin, dexamethasone), were invalid. The patient showed inadequate response, suggesting that this treatment was not employed on the basis of the immunophenotype. FLAG-IDA regimen (fludarabine, cytarabine [Ara-C], granulocyte-colony stimulating factor [G-CSF] and idarubicin), which is usually applied to eliminate leukemia cells, was administered combining with sorafenib as an effective induction chemotherapy. The case achieved long-term survival following the allogeneic hematopoietic stem cell transplantation (allo-HSCT). We recommend that adult ETP-ALL patients can be treated with a myeloid-oriented chemotherapy (as frontline induction treatment) along with gene-targeting inhibitors, followed by allo-HSCT.
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Affiliation(s)
- Jianping Mao
- Department of Hematology, The First People's Hospital of Lianyungang, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, People's Republic of China
| | - Lianguo Xue
- Department of Hematology, The First People's Hospital of Lianyungang, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, People's Republic of China
| | - Haiqing Wang
- Department of Laboratory medicine, The First People's Hospital of Lianyungang, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, People's Republic of China
| | - Yuanxin Zhu
- Department of Hematology, The First People's Hospital of Lianyungang, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, People's Republic of China
| | - Juan Wang
- Department of Pediatrics, The First People's Hospital of Lianyungang, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, People's Republic of China
| | - Lidong Zhao
- Department of Hematology, The First People's Hospital of Lianyungang, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, People's Republic of China
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12
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Garg N, Gupta R, Kotru M. CD34 is not Expressed by Blasts in a Third of B-ALL Patients and its Negativity is associated with Aberrant Marker Expression: A Retrospective Analysis. Asian Pac J Cancer Prev 2021; 22:919-925. [PMID: 33773558 PMCID: PMC8286681 DOI: 10.31557/apjcp.2021.22.3.919] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND CD34 antigen is expressed by early hematopoietic progenitor cells and acute leukemia cells. Its expression is associated with good prognosis in acute myeloid leukemia. Literature is sparse on its prognostic significance in B- acute lymphoblastic leukemia (B-ALL) especially from India. Hence the present study was undertaken to analyse the frequency of CD34 expression in B-ALL in Indian patients and determine its prognostic significance by associating with other prognostic markers and aberrant antigen expression. METHODS Seventy-five B-ALL patients diagnosed by flow cytometry over a period of 3½ year were studied. Correlation of CD34 expression was studied with gender, age, total leucocyte count (TLC), French-American-British (FAB) morphological type, immuno-phenotypic markers, cytogenetics and minimal residual disease. Differences between groups were evaluated using Student's T-test for quantitative data and Chi-square test/Fishers exact T-test for qualitative variables. P value.
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Affiliation(s)
- Neha Garg
- Department of Pathology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Dilshad Garden, New Delhi, India
| | - Richa Gupta
- Department of Pathology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Dilshad Garden, New Delhi, India
| | - Mrinalini Kotru
- Department of Pathology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Dilshad Garden, New Delhi, India
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13
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Jamal S, Meraj F, Mansoor N, Parveen S, Shaikh A, Jabbar N. Distribution of subtypes and immunophenotypic characterization of 1379 cases of paediatric acute leukaemia. Pak J Med Sci 2021; 37:805-811. [PMID: 34104169 PMCID: PMC8155440 DOI: 10.12669/pjms.37.3.3552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objectives: Acute leukaemia is the most common and highly curable childhood malignancy; subtyping and identification of antigens via immunophenotyping helps in treatment plan as well as minimal residual disease monitoring. Methods: This retrospective study was conducted at the Haematology section of the clinical laboratories of Ziauddin University Hospital and The Indus Hospital, Karachi conducted at January 1st, 2012 to December 31st, 2017. The study included 1379 cases of de novo acute leukemia from 2012 to 2017. Among these, 80% were diagnosed by using four color flowcytometry (FACS Calibur), 9% and 11% via immunohistochemistry on bone marrow trephine biopsy samples and morphological examination respectively. Results: The mean age of patients was 7.4 ± 4.3 years while male to female ratio was 1.75:1. Lymphoblastic leukaemia accounted for 77.2% and myeloid leukaemia 21.2%. Amongst lymphoblastic lineage, B-ALL was 80.4% while T-ALL was 19.6%. Among the phenotypic expression of B-ALL, CD79a (99.8%) had the highest positivity. In B-ALL, CD13 (29.8%) was the most common aberrant myeloid marker. Aberrant expression of CD79a observed in 11.1% of T-ALL cases. In non APL AML, aberrant expression of CD79a and CD19 was observed in 6.6% and 5.5% of cases respectively. Conclusion: Overall immunophenotypic profile, expression of aberrant phenotypes and subtype distribution in our patients was similar to international literature except for a relatively high frequency of T-ALL which was discordant from the western data.
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Affiliation(s)
- Saba Jamal
- Dr. Saba Jamal (MBBS) Diplomate American Board of Anatomic and Clinical Pathology, Diplomate American Board of Hematology), Haematology Clinical Laboratory, The Indus Hospital, Karachi, Pakistan
| | - Fatima Meraj
- Dr. Fatima Meraj (MBBS, MCPS, FCPS), Haematology Clinical Laboratory, The Indus Hospital, Karachi, Pakistan
| | - Neelum Mansoor
- Dr. Neelum Mansoor (MBBS, FCPS), Haematology Clinical Laboratory, The Indus Hospital, Karachi, Pakistan
| | - Sadia Parveen
- Ms. Sadia Parveen (M.Phil.), Indus Hospital Research Center, The Indus Hospital, Karachi, Pakistan
| | - Ameerah Shaikh
- Ameerah Shaikh, Medical Student, Ziauddin Medical College, Karachi, Pakistan
| | - Naeem Jabbar
- Dr. Naeem Jabbar (MBBS, FCPS). Paediatric Haematology Oncology, The Indus Hospital, Karachi, Pakistan
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14
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Gupta M, Monga L, Mehrotra D, Chhabra S, Singhal S, Sen R. --Immunophenotypic Aberrancies in Acute Leukemia: A Tertiary Care Centre Experience. Oman Med J 2021; 36:e218. [PMID: 33585041 PMCID: PMC7874438 DOI: 10.5001/omj.2021.03] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/03/2020] [Indexed: 11/03/2022] Open
Abstract
Objectives Acute leukemias (AL) are a heterogeneous group of hematological malignancies with the presence of 20% or more blasts in the peripheral blood or bone marrow. Malignant cells display characteristic patterns of surface antigenic expression. Aberrant phenotypes are defined as patterns of antigen expression on neoplastic cells different from the process of normal hematopoietic maturation. We sought to evaluate the occurrence of aberrant phenotypes in newly diagnosed cases of AL. Methods The study included 100 patients in whom both bone marrow aspiration and flow cytometry were performed. Patients with blasts > 20% of all ages were included in the study. Flow cytometric analysis was done using the monoclonal antibody panel of peripheral blood/bone marrow. Results Out of 100 cases, 53 were categorized as acute myeloid leukemia (AML), 43 as acute lymphoid leukemia (ALL), and four cases of mixed phenotypic acute leukemia (MPAL). ALL were subcategorized based on immunophenotyping into B-ALL and T-ALL, which comprised 88.4% and 11.6%, respectively, of total ALL (43.0%) cases. Cluster of differentiation 33 (CD33) and CD13 were the most commonly expressed antigens in AML, with CD7 being the most common aberrancy. CD19 was expressed in all B-ALL cases followed by cCD79a, CD10, Tdt (86.8%) with CD13 being the most common aberrancy. cCD3, CD7, and CD5 were expressed in all T-ALL cases with aberrant antigen expression in 80.0% of T-ALL cases. MPAL cases showed expression of B/myeloid antigens. Conclusions The diagnosis and classification of leukemia rely on the simultaneous application of cytomorphology, cytochemistry, flow cytometry, cytogenetics, and molecular techniques. Flow cytometry is of great help in the diagnosis of AL, particularly in ALL for lineage assignment and in classifying MPAL. It also helps in detecting aberrant antigen expression and assisting in minimal residual disease detection.
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Affiliation(s)
- Monika Gupta
- Department of Pathology, Post Graduate Institute of Medical Sciences, University of Health Sciences, Rohtak, India
| | - Lovekesh Monga
- Department of Pathology, Post Graduate Institute of Medical Sciences, University of Health Sciences, Rohtak, India
| | - Dimple Mehrotra
- Department of Pathology, Post Graduate Institute of Medical Sciences, University of Health Sciences, Rohtak, India
| | - Sonia Chhabra
- Department of Pathology, Post Graduate Institute of Medical Sciences, University of Health Sciences, Rohtak, India
| | - Shivani Singhal
- Department of Pathology, Post Graduate Institute of Medical Sciences, University of Health Sciences, Rohtak, India
| | - Rajeev Sen
- Department of Pathology, Post Graduate Institute of Medical Sciences, University of Health Sciences, Rohtak, India
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15
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Cherian S, Soma LA. How I Diagnose Minimal/Measurable Residual Disease in B Lymphoblastic Leukemia/Lymphoma by Flow Cytometry. Am J Clin Pathol 2021; 155:38-54. [PMID: 33236071 DOI: 10.1093/ajcp/aqaa242] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Assessment for minimal/measurable residual disease (MRD) is a powerful prognostic factor in B lymphoblastic leukemia/lymphoma (B-LL/L) that is quickly becoming standard of care in assessing patients with B-LL/L posttherapy. MRD can be assessed using methodologies including flow cytometry and molecular genetics, with the former being rapid, relatively inexpensive, and widely applicable in many hematopathology/flow cytometry laboratories. METHODS This article presents an approach to MRD detection in B-LL/L by flow cytometry through case presentations with illustration of several potential pitfalls. We review normal maturation patterns, antigens used for assessment, flow panels that can be utilized, considerations to be made during therapy, and clinical impact. The benefits and drawbacks when using the "different from normal" and "leukemia associated phenotype" approaches are considered. RESULTS Evaluation for MRD in B-LL/L by flow cytometry relies on a knowledge of normal immunophenotypic patterns associated with B-cell maturation in states of rest and marrow regeneration so that one can identify patterns of antigen expression that differentiate abnormal, leukemic populations from regenerating hematogones or B-cell precursors. The nature of therapy can affect normal patterns, a phenomenon especially important to take into consideration given the increased use of targeted therapies in the treatment of B-LL/L. CONCLUSIONS Flow cytometry is widely available in many laboratories and is a cost-effective way to evaluate for B-LL/L MRD. However, panel validation and interpreter education are crucial for accurate assessment.
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Affiliation(s)
- Sindhu Cherian
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle
| | - Lorinda A Soma
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle
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16
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Precursor B-lineage acute lymphoblastic leukemia patients with aberrant natural killer cell and T cell - lineage antigen expression: experience from a tertiary cancer care center. Hematol Transfus Cell Ther 2020; 44:143-150. [PMID: 33526373 PMCID: PMC9123560 DOI: 10.1016/j.htct.2020.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/11/2020] [Accepted: 08/06/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction Flow cytometric immunophenotyping (FCI) plays a major role in diagnosing hematologic malignancies. In patients diagnosed with precursor B-lineage acute lymphoblastic leukemia (B-ALL), expression of certain non-lineage/cross lineage antigens is of prognostic and cytogenetic relevance. There is a paucity of studies that have comprehensively analyzed the clinical and laboratory profiles of B-ALL patients showing aberrant T/natural killer (NK) cell antigen expression. Materials and methods This is a prospective study where 152 consecutive B-ALL patients were analyzed for aberrant expression of T/NK cell antigens (CD1a, CD5, CD4, CD7, CD8 and CD56) by FCI. The clinical and laboratory profile of these T/NK-cell antigen-expressing B-ALL patients was statistically analyzed against conventional B-ALL patients. Results In our B-ALL cohort, CD5, CD7 and CD56 expression were observed in one, six and nine patients, respectively. CD56-expressing B-ALL patients were predominantly children (89%) and presented as standard clinical risk (p = 0.010) disease with frequent ETV6-RUNX1 fusion (p = 0.021) positivity. On the contrary, CD7-expressing B-ALL patients were adolescent-young adult/adult-age skewed (83%) and had an adverse cytogenetic profile (p = 0.001), especially for the frequent presence of BCR-ABL1 fusion (p = 0.004) and KMT2A rearrangement (p = 0.045). CD7-expressing B-ALL patients had inferior event-free survival (p = 0.040) than their CD56-expressing counterparts, but there was no significant difference in the overall survival (p = 0.317). Conclusion In comparison to conventional B-ALL patients, there are significant differences in the age, cytogenetic profile and event-free survival of T/NK-cell antigen-expressing B-ALL patients.
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17
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Aoki M, Kobayashi K, Taji Y, Shimizu Y, Ohta A, Watanabe A, Fukushima T, Tanaka R, Ebihara Y. Pediatric B-lineage Acute Lymphoblastic Leukemia With CD56 Expression: A Report of 2 Cases. J Pediatr Hematol Oncol 2020; 42:249-250. [PMID: 31876778 DOI: 10.1097/mph.0000000000001704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | - Yuki Shimizu
- Pediatric Hematology/Oncology, Saitama Medical University International Medical Center Saitama, Japan
| | - Atsuhiko Ohta
- Pediatric Hematology/Oncology, Saitama Medical University International Medical Center Saitama, Japan
| | - Atsuko Watanabe
- Pediatric Hematology/Oncology, Saitama Medical University International Medical Center Saitama, Japan
| | - Takashi Fukushima
- Pediatric Hematology/Oncology, Saitama Medical University International Medical Center Saitama, Japan
| | - Ryuhei Tanaka
- Pediatric Hematology/Oncology, Saitama Medical University International Medical Center Saitama, Japan
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18
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Rezaei MS, Esfandiari N, Refoua S, Shamaei M. Characterization of Immunophenotypic Aberrancies in Adult and Childhood Acute Lymphoblastic Leukemia: Lessons from Regional Variation. IRANIAN JOURNAL OF PATHOLOGY 2020; 15:1-7. [PMID: 32095142 PMCID: PMC6995678 DOI: 10.30699/ijp.2019.93974.1926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background & Objective: Although the antigen expression patterns of acute lymphoblastic leukemia (ALL) are well known, this study attempted to evaluate commonly used immune markers for immunophenotyping of acute leukemia to set the minimum of necessary diagnostic panels by flow cytometry. Methods: This study evaluated 89 patients referred from all over the country to the Iranian Blood Transfusion Organization (IBTO) in Tehran from 2013 to 2015. We compared the immunophenotype patterns of childhood and adult ALLs including 69(77.5%) B-cell lymphoblastic lymphoma (B-LBL), 2(2.2%) Burkitt’s lymphoma (BL), and 18(20.2%) T-cell lymphoblastic lymphoma (T-LBL) cases using flowcytometry with broad antibody panel. Results: CD19 and CD79a were the most frequent markers for B-LBL while CD7 was the most sensitive marker in T-LBL; the frequency of CD7, CD3, and CD5 antigens were 100%, 38.9%, and 88.9%, respectively. TdT+/CD34+ was significantly higher in adult B-LBLs than children, which indicates blast cells are more immature in adults. In addition, CD10 and cCD79a were significantly higher in children with B-LBL like as CD5 and CD8 in children with T-LBL. Aberrant phenotypes including CD13, CD33, CD7, and CD117 were found in 7(10.1%) cases of B-LBL. These phenotypes were CD117, HLA-DR, and CD33 in 7(38/9%) cases of T-LBL. Expression of CD117 aberrant myeloid antigen was significantly more associated with T-LBL than with B-lineage ALL. Conclusion: Significant differences were observed in antigen-expression patterns between adult and childhood ALLs. Further studies are needed to correlate specific markers with recurrent cytogenetic abnormalities and prognosis with therapeutic response.
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Affiliation(s)
- Mitra Sadat Rezaei
- Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,High Institute for Research and Education in Blood Transfusion Medicine, Iranian Blood Transfusion Organization, Tehran, Iran.,Department of Pathology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Najmeh Esfandiari
- Department of Pathology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sandra Refoua
- High Institute for Research and Education in Blood Transfusion Medicine, Iranian Blood Transfusion Organization, Tehran, Iran
| | - Masoud Shamaei
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis, Tehran, Iran
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Citalan-Madrid AF, Cabral-Pacheco GA, Martinez-de-Villarreal LE, Villarreal-Martinez L, Ibarra-Ramirez M, Garza-Veloz I, Cardenas-Vargas E, Marino-Martinez I, Martinez-Fierro ML. Proteomic tools and new insights for the study of B-cell precursor acute lymphoblastic leukemia. ACTA ACUST UNITED AC 2019; 24:637-650. [PMID: 31514680 DOI: 10.1080/16078454.2019.1664127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
B-cell precursor acute lymphoblastic leukemia (BCP-ALL) is a hematological malignancy of immature B-cell precursors, affecting children more often than adults. The etiology of BCP-ALL is still unknown, but environmental factors, sex, race or ethnicity, and genomic alterations influence the development of the disease. Tools based on protein detection, such as flow cytometry, mass spectrometry, mass cytometry and reverse phase protein array, represent an opportunity to investigate BCP-ALL pathogenesis and to identify new biomarkers of disease. This review aims to document the recent advancements with respect to applications of proteomic technologies to study mechanisms of leukemogenesis, how this information could be used in the discovery of biological targets, and finally we describe the challenges of application of proteomic tools for the approach of BCP-ALL.
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Affiliation(s)
- Alí F Citalan-Madrid
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University , Zacatecas , Mexico
| | - Griselda A Cabral-Pacheco
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University , Zacatecas , Mexico.,Program of Doctorate in Sciences with Orientation in Molecular Medicine, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University , Zacatecas , Mexico
| | | | - Laura Villarreal-Martinez
- Hematology Service, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autonoma de Nuevo Leon , Monterrey , Mexico
| | - Marisol Ibarra-Ramirez
- Departamento de Genetica, Facultad de Medicina, Universidad Autónoma de Nuevo Leon , Monterrey , Mexico
| | - Idalia Garza-Veloz
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University , Zacatecas , Mexico.,Program of Doctorate in Sciences with Orientation in Molecular Medicine, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University , Zacatecas , Mexico
| | - Edith Cardenas-Vargas
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University , Zacatecas , Mexico.,Program of Doctorate in Sciences with Orientation in Molecular Medicine, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University , Zacatecas , Mexico.,Hospital General Zacatecas 'Luz González Cosío' , Zacatecas , Mexico
| | - Ivan Marino-Martinez
- Departamento de Patologia, Facultad de Medicina, Universidad Autonoma de Nuevo Leon , Monterrey , Mexico
| | - Margarita L Martinez-Fierro
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University , Zacatecas , Mexico.,Program of Doctorate in Sciences with Orientation in Molecular Medicine, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University , Zacatecas , Mexico
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20
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Hu W, Soper SA, Jackson JM. Time-Delayed Integration-Spectral Flow Cytometer (TDI-SFC) for Low-Abundance-Cell Immunophenotyping. Anal Chem 2019; 91:4656-4664. [PMID: 30817129 PMCID: PMC6554645 DOI: 10.1021/acs.analchem.9b00021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
We describe a unique flow cytometer (TDI-SFC) for the immunophenotyping of low-abundance cells, particularly when cell counts are sample-limited and operationally difficult for analysis by fluorescence microscopy (>100 cells) or multiparameter flow cytometry (MFC, <10 000 cells). TDI-SFC combines the high spectral resolution of spectral flow cytometry (SFC) with a CCD operated in time-delayed integration (TDI) for improved duty cycle and sensitivity. Cells were focused with a 1D-sheathing microfluidic device, and fluorescence emission generated from a 488 nm laser was collected by epi-illumination and dispersed along one axis of a CCD by a spectrograph. Along the other axis, the CCD's shift rate was clocked at a rate that closely matched the cells' velocity through the field of view. This TDI-SFC format allowed the CCD shutter to remain open during signal acquisition, providing a duty cycle ∼100% and assurance that ∼95% cells were interrogated. We used fluorescent beads to optimize synchronization of TDI clocking with the sheathed-cell velocity and to improve sensitivity via the excitation intensity, epi-illumination numerical aperture, and integration time. TDI achieved integrated signals of 106 counts at a signal-to-noise ratio (SNR) of 610 for beads corresponding to a load of 4 × 105 antibodies. We also evaluated multiplexing capabilities by spectral deconvolution and undertook a proof-of-concept application to immunophenotype low-abundance cells; the demonstration consisted of immunophenotyping a model cell line, in this case SUP-B15 cells representing B-cell acute lymphoblastic leukemia (B-ALL). The B-ALL cell line was stained against a leukemic marker (terminal deoxynucleotidyl transferase, TdT), and we successfully used spectral unmixing to discriminate TdT(+) cells from TdT(-) cells even at low cell counts (∼100 cells). The TDI-SFC could potentially be used in any application requiring the immunophenotyping of low-abundance cells, such as in monitoring measurable residual disease in acute leukemias following affinity enrichment of circulating leukemia cells from peripheral blood.
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Affiliation(s)
- Wenting Hu
- Department of Chemistry, University of Kansas, Lawrence, Kansas 66045, United States
- Center of BioModular Multi-Scale Systems for Precision Medicine (CBM), University of Kansas, Lawrence, Kansas 66045, United States
| | - Steven A. Soper
- Department of Chemistry, University of Kansas, Lawrence, Kansas 66045, United States
- Center of BioModular Multi-Scale Systems for Precision Medicine (CBM), University of Kansas, Lawrence, Kansas 66045, United States
- Department of Mechanical Engineering, University of Kansas, Lawrence, Kansas 66045, United States
- Department of Cancer Biology, University of Kansas Medical Center, Kansas City, Kansas 66160, United States
| | - J. Matt Jackson
- Department of Chemistry, University of Kansas, Lawrence, Kansas 66045, United States
- Center of BioModular Multi-Scale Systems for Precision Medicine (CBM), University of Kansas, Lawrence, Kansas 66045, United States
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21
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Gupta N, Pawar R, Banerjee S, Brahma S, Rath A, Shewale S, Parihar M, Singh M, Arun SR, Krishnan S, Bhatacharyya A, Das A, Kumar J, Bhave S, Radhakrishnan V, Nair R, Chandy M, Arora N, Mishra D. Spectrum and Immunophenotypic Profile of Acute Leukemia: A Tertiary Center Flow Cytometry Experience. Mediterr J Hematol Infect Dis 2019; 11:e2019017. [PMID: 30858955 PMCID: PMC6402547 DOI: 10.4084/mjhid.2019.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 01/19/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND For diagnosis, sub-categorization and follow up of Acute Leukemia (AL), phenotypic analysis using flow cytometry is mandatory. MATERIAL AND METHODS We retrospectively analyzed immunophenotypic data along with cytogenetics/molecular genetics data (wherever available) from 631 consecutive cases of AL diagnosed at our flow cytometry laboratory from January 2014 to August 2017. RESULTS Of the total 631 cases, 52.9% (n=334) were acute lymphoblastic leukemia (ALL), 43.9% (n=277) acute myeloid leukemia (AML), 2.2% (n=14) mixed phenotypic acute leukemia (MPAL), 0.5% (n=3) acute undifferentiated leukemia (AUL) and 0.5% (n=3) chronic myeloid leukemia in blast crisis (CML-BC). ALL cases comprised of 81.7% (n=273/334) B-cell ALLs (95.2%, n=260/273 common B-ALLs and 4.8%, n=13/273 Pro B-ALLs). CD13 was the commonest cross lineage antigen, expressed in B-ALL (25.6%, n=70/273), followed by CD33 (17.9%, n=49) and combined CD13/CD33 (11.3%, n=31/273) expression. T-ALLs constituted 18.3% (n=61/334) of total ALLs and included 27.9% (n=17/61) cortical T- ALLs. CD13 was commonest (32.7%, n=20/61) aberrantly expressed antigen in T-ALLs, followed by CD117 (19.1%, n=9/47). AML cases included 32.1% (n=89/277) AML with recurrent genetic abnormalities, 9.0% (n=25/277) with FLT3/NPM1c mutation and 58.9% (n=163/277) AML NOS including 14.7% (n=24/163) AML M4/M5, 1.8% (n=3/163) AML M6 and 3.7% (n=6/163) AML M7. In AMLs, CD19 aberrancy was the most common (20.2%, n=56/277) followed by CD56 (15.8%, n=42/265). CONCLUSIONS In this study, we document the spectrum, correlate the immunophenotype with genetic data of all leukemias, especially concerning T-ALL where the data from India is scarce.
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Affiliation(s)
- Nishit Gupta
- Department of Laboratory Hematology, Tata Medical Center, Kolkata
| | - Ravikiran Pawar
- Department of Laboratory Hematology, Tata Medical Center, Kolkata
| | | | - Subhajit Brahma
- Department of Laboratory Hematology, Tata Medical Center, Kolkata
| | - Asish Rath
- Department of Laboratory Hematology, Tata Medical Center, Kolkata
| | - Sundar Shewale
- Department of Laboratory Hematology, Tata Medical Center, Kolkata
| | - Mayur Parihar
- Department of Laboratory Hematology and Cytogenetics, Tata Medical Center, Kolkata
| | - Manish Singh
- Department of Laboratory Hematology and Cytogenetics, Tata Medical Center, Kolkata
| | - S R Arun
- Department of Laboratory Hematology and Cytogenetics, Tata Medical Center, Kolkata
| | | | | | - Anirban Das
- Department of Pediatric Oncology, Tata Medical Center, Kolkata
| | - Jeevan Kumar
- Department of Clinical Hematology, Tata Medical Center, Kolkata
| | - Saurabh Bhave
- Department of Clinical Hematology, Tata Medical Center, Kolkata
| | | | - Reena Nair
- Department of Clinical Hematology, Tata Medical Center, Kolkata
| | - Mammen Chandy
- Department of Clinical Hematology, Tata Medical Center, Kolkata
| | - Neeraj Arora
- Department of Laboratory Hematology and Molecular Genetics, Tata Medical Center, Kolkata
| | - Deepak Mishra
- Department of Laboratory Hematology and Molecular Genetics, Tata Medical Center, Kolkata
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Staley EM, Feldman AZ, Koenig RG, Hill B. CD5 positive B-ALL, a uniquely aggressive subcategory of B-ALL? A case report and brief review of the literature. Pediatr Blood Cancer 2019; 66:e27484. [PMID: 30270496 DOI: 10.1002/pbc.27484] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/06/2018] [Accepted: 09/10/2018] [Indexed: 11/06/2022]
Abstract
CD5 antigen expression in B-cell acute lymphoblastic leukemia (B-ALL) is exceptionally rare. There are six detailed case reports in the literature, with only 16 cases described. Case series analyzing the frequency of aberrant B-ALL immunophenotypes suggest that this variant may occur in as little as 2-4.5% of all B-ALL cases, with one series having no CD5+ positive cases. Herein we report a case of CD5+ B-ALL in a 15-year-old female, and review the previously reported cases. As limited information is available, more data from prospective clinical trials are required to determine whether CD5 positivity portends a poorer prognosis.
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Affiliation(s)
- Elizabeth M Staley
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Alexander Z Feldman
- Department of Pathology, Nationwide Children's Hospital, Birmingham, Alabama
| | - Richard G Koenig
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Benjamin Hill
- Department of Pathology, Children's of Alabama, Birmingham, Alabama
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B-acute Lymphoblastic Leukemia with Bright CD45 and Moderate Side Scatter Simulating Monocytoid Population: An Unusual Phenotype. Indian J Hematol Blood Transfus 2018; 34:358-359. [PMID: 29622886 DOI: 10.1007/s12288-017-0896-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022] Open
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25
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Shaver AC, Seegmiller AC. B Lymphoblastic Leukemia Minimal Residual Disease Assessment by Flow Cytometric Analysis. Clin Lab Med 2017; 37:771-785. [DOI: 10.1016/j.cll.2017.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Aref S, Azmy E, El-Bakry K, Ibrahim L, Mabed M. Prognostic impact of CD200 and CD56 expression in adult acute lymphoblastic leukemia patients. ACTA ACUST UNITED AC 2017; 23:263-270. [PMID: 29161980 DOI: 10.1080/10245332.2017.1404276] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The aim of the study is to determine the prognostic relevance of CD200/ CD56 expression in adult acute lymphoblastic leukemia patients. METHODS The expression of CD200 and CD56 by blast cells was assessed by flow cytometry before the start of chemotherapy in 70 B-ALL patients. RESULTS Positive expression of CD200 was detected in forty-six patients (66%) and CD56 was detected in 7 patients (10%) out of 70 patients, respectively. Only three patients (4.3%) had co-expression for CD200+ and CD56+. Splenomegaly and thrombocytopenia were frequently observed more in CD200+ patients. Increased frequency of CD34+ was associated with CD200+and CD56+ patients. The CD200+ and CD56+ subgroups of B-ALL patients had inferior OS and disease free survival compared to CD 200- and CD 56- patients. CONCLUSIONS CD200+ and/or CD56+ positive expression in B-ALL patients at diagnosis is a poor prognostic biomarker. Identification of CD200+ and CD56+ expression at diagnosis is recommended for a better stratification of adult B-ALL patients.
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Affiliation(s)
- Salah Aref
- a Hematology Unit, Mansoura University Oncology Center , Mansoura University , Mansoura , Egypt
| | - Emad Azmy
- b Hematology Unit, Internal Medicine Department, Faculty of Medicine , Mansoura University , Mansoura , Egypt
| | - Kadry El-Bakry
- c Physiology, Zoology Department, Faculty of Science , Damietta University , Damietta , Egypt
| | - Lobna Ibrahim
- c Physiology, Zoology Department, Faculty of Science , Damietta University , Damietta , Egypt
| | - Mohamed Mabed
- b Hematology Unit, Internal Medicine Department, Faculty of Medicine , Mansoura University , Mansoura , Egypt
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Cho SF, Lin L, Xing L, Yu T, Wen K, Anderson KC, Tai YT. Monoclonal Antibody: A New Treatment Strategy against Multiple Myeloma. Antibodies (Basel) 2017; 6:antib6040018. [PMID: 31548533 PMCID: PMC6698817 DOI: 10.3390/antib6040018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 11/09/2017] [Accepted: 11/10/2017] [Indexed: 12/22/2022] Open
Abstract
2015 was a groundbreaking year for the multiple myeloma community partly due to the breakthrough approval of the first two monoclonal antibodies in the treatment for patients with relapsed and refractory disease. Despite early disappointments, monoclonal antibodies targeting CD38 (daratumumab) and signaling lymphocytic activation molecule F7 (SLAMF7) (elotuzumab) have become available for patients with multiple myeloma in the same year. Specifically, phase 3 clinical trials of combination therapies incorporating daratumumab or elotuzumab indicate both efficacy and a very favorable toxicity profile. These therapeutic monoclonal antibodies for multiple myeloma can kill target cells via antibody-dependent cell-mediated cytotoxicity, complement-dependent cytotoxicity, and antibody-dependent phagocytosis, as well as by direct blockade of signaling cascades. In addition, their immunomodulatory effects may simultaneously inhibit the immunosuppressive bone marrow microenvironment and restore the key function of immune effector cells. In this review, we focus on monoclonal antibodies that have shown clinical efficacy or promising preclinical anti-multiple myeloma activities that warrant further clinical development. We summarize mechanisms that account for the in vitro and in vivo anti-myeloma effects of these monoclonal antibodies, as well as relevant preclinical and clinical results. Monoclonal antibody-based immunotherapies have already and will continue to transform the treatment landscape in multiple myeloma.
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Affiliation(s)
- Shih-Feng Cho
- Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.
| | - Liang Lin
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.
| | - Lijie Xing
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, No. 324, Jingwu Road, Jinan 250021, China.
| | - Tengteng Yu
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.
| | - Kenneth Wen
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.
| | - Kenneth C Anderson
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.
| | - Yu-Tzu Tai
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.
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Aref S, Azmy E, El-Bakry K, Ibrahim L, Abdel Aziz S. Prognostic impact of CD200 and CD56 expression in pediatric B-cell acute lymphoblastic leukemia patients. Pediatr Hematol Oncol 2017; 34:275-285. [PMID: 29144828 DOI: 10.1080/08880018.2017.1363836] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to determine the prognostic impact of CD200 and CD56 expression in pediatric B cell acute lymphoblastic leukemia (B-ALL) patients, both of which have been implicated in immune tolerance and previously suggested as independent risk factors. CD200 has a central role in immune tolerance that protects stem cells and other critical tissues from immune damage. The expression of CD200/CD56 in leukemic blasts were assessed in leukemic blasts before chemotherapy in 43 bone marrow (BM) and/or peripheral blood (PB) samples by flow cytometry. Twenty eight of 43 B-ALL cases (65%) showed CD200 positive expression, 5 of 43 cases (11.6%) showed CD56 expression, and only 2 patients (4.7%) expressed both CD200 and CD56. Patients with CD200+ and CD56+ were significantly associated with lower platelet count; less tendency for induction of remission response as compared to negative ones (p = .01 for both). The overall survival (OS) and DFS were significantly shorter in CD200+ and CD56+ cases as compared to those with CD200- and CD56- expression. In conclusion, CD200 and/or CD56 positive expression in B-ALL at diagnosis suggest a poor prognosis and may be associated with biological aggressiveness.
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Affiliation(s)
- Salah Aref
- a Clinical Pathology Department, Hematology Unit , Mansoura University Oncology Center, Mansoura University , Mansoura , Egypt
| | - Emad Azmy
- b Internal Medicine Department , Hematology Unit , Internal medicine department , Faculty of Medicine, Mansoura university , Mansoura , Egypt
| | - Kadry El-Bakry
- c Zoology Department , Physiology , Zoology department , Faculty of science, Damietta University , Damietta , Egypt
| | - Lobna Ibrahim
- c Zoology Department , Physiology , Zoology department , Faculty of science, Damietta University , Damietta , Egypt
| | - Sherin Abdel Aziz
- a Clinical Pathology Department, Hematology Unit , Mansoura University Oncology Center, Mansoura University , Mansoura , Egypt
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Jalal SD, Al-Allawi NAS, Al Doski AAS. Immunophenotypic aberrancies in acute lymphoblastic leukemia from 282 Iraqi patients. Int J Lab Hematol 2017; 39:625-632. [PMID: 28722319 DOI: 10.1111/ijlh.12716] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 06/19/2017] [Indexed: 01/11/2023]
Abstract
INTRODUCTION The identification of aberrancies in leukemia-associated immunophenotype (LAIP) of acute lymphoblastic leukemia (ALL) is quite important in the assessment of minimal residual disease (MRD). This study, the first from Iraq, aimed to assess the frequency and patterns of LAIP among Iraqi patients with ALL, to establish future strategies for evaluating MRD. METHODS A total of 282 newly diagnosed Iraqi ALL cases were analyzed with six-parameter flow cytometry using a panel of 29 monoclonal antibodies. RESULTS Immunological subtyping revealed that 85.5% of cases were B-ALL and the remainder T-ALL. LAIP was detected in 97.1% of B-ALL, and in 26.8% of T-ALL. The asynchronous maturation-associated antigen patterns in B-ALL were CD10strong+ /TdTdim+ , CD38dim+ /CD34+ , CD10dim+ /CD34+ , CD10strong /CD20strong+ , CD20strong+ /CD34+, and CD45dim+ /CD20strong+ in 84.6%, while the cross-lineage myeloid expression was seen in 81.3% and aberrant T-cell antigen expression in 6.2%. For T-ALL, asynchronous maturation-associated antigen patterns included the following: CD1a+ /CD5+ /sCD3+ and CD34+ /sCD3+ in 12.2%. Myeloid and B-cell antigen expression were each identified in 7.3% of T-ALL. No significant differences in LAIP were found between children and adults. CONCLUSION The high rates and the patterns of LAIP particularly in Iraqi B-ALL patients may allow the development of more cost-effective strategies for MRD monitoring.
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Affiliation(s)
- S D Jalal
- Department of Pathology, College of Medicine, University of Sulaimani, Sulaimani, Iraq
| | - N A S Al-Allawi
- Department of Pathology, College of Medicine, University of Duhok, Duhok, Iraq
| | - A A S Al Doski
- Department of Pathology, College of Medicine, University of Duhok, Duhok, Iraq
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Pediatric Philadelphia-positive B lymphoblastic leukemia with CD56 expression and L2 morphology: Case report and review of the literature. HUMAN PATHOLOGY: CASE REPORTS 2017. [DOI: 10.1016/j.ehpc.2016.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Newton JG, Horan JT, Newman S, Rossi MR, Ketterling RP, Park SI. CD36-positive B-lymphoblasts Predict Poor Outcome in Children With B-lymphoblastic Leukemia. Pediatr Dev Pathol 2017; 20:224-231. [PMID: 28521628 DOI: 10.1177/1093526616688753] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective We observed that pediatric patients with B lymphoblastic leukemia which expressed CD36 at diagnosis seemed to have worse outcome than patients whose blasts did not. Here, we describe the patient, disease characteristics, pathological, molecular, and genetic features and outcomes of patients with CD36+ B-LL compared to patients with CD36- B-LL. Methods We retrospectively reviewed all flow cytometry reports from September 2008 to December 2015 to identify patients diagnosed at our institution with CD36 expression on B lymphoblasts. CD36- control patients were chosen from our leukemia database and matched 2:1 to CD36+ patients for National Cancer Institute (NCI) risk group at diagnosis. We reviewed diagnostic marrow slides for cytoplasmic granules and abstracted clinical data from patient charts. To identify underlying genetic abnormalities, clinical FISH testing and RNA sequencing was performed on 5 of our CD36+ patients, and RNA-seq data from the NIH Therapeutically Applicable Research to Generate Effective Treatments (TARGET) ALL Expansion Phase 2 data set were examined. Results Twenty-five of 366 (6.83%) patients diagnosed at our institution in the study period had CD36+ blasts. With a median follow-up of 5.32 years, 5-year event-free survival (EFS) and overall survival (OS) were significantly worse for CD36+ patients compared to CD36- patients who were NCI Standard Risk at diagnosis (EFS: 60% ± 15.49 vs 95% ± 4.87, P = .016; OS: 90% ± 9.5 vs 100%, P = .019). NCI Standard Risk patients whose blasts were both CD36+ and had granules had the worst survival compared to CD36- patients without granules (EFS 25% ± 21.65 vs 95% ± 4.87, P = .0004). From our CD36+ patients and the TARGET database, we found 2 ABL2 mutations, 1 PDGFRB mutation, and 2 NRAS mutations. Conclusions For NCI Standard Risk patients, CD36 expression on B-lymphoblasts identifies patients with B-LL who have especially poor outcome. This may be due to underlying genetic abnormalities that may be amenable to targeted therapy.
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Affiliation(s)
- Joanna G Newton
- 1 Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University, Children's Healthcare of Atlanta - Scottish Rite, Atlanta, Georgia, USA
| | - John T Horan
- 2 Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University, Children's Healthcare of Atlanta -Egleston, Atlanta, Georgia, USA
| | - Scott Newman
- 3 Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Michael R Rossi
- 4 Department of Radiation Oncology, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia, USA
| | - Rhett P Ketterling
- 5 Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Sunita I Park
- 6 Department of Pathology, Children's Healthcare of Atlanta - Egleston, Emory University, Atlanta, Georgia, USA
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Theunissen PMJ, Sedek L, De Haas V, Szczepanski T, Van Der Sluijs A, Mejstrikova E, Nováková M, Kalina T, Lecrevisse Q, Orfao A, Lankester AC, van Dongen JJM, Van Der Velden VHJ. Detailed immunophenotyping of B-cell precursors in regenerating bone marrow of acute lymphoblastic leukaemia patients: implications for minimal residual disease detection. Br J Haematol 2017; 178:257-266. [DOI: 10.1111/bjh.14682] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/18/2017] [Indexed: 01/23/2023]
Affiliation(s)
- Prisca M. J. Theunissen
- Department of Immunology; Erasmus MC, University Medical Centre Rotterdam; Rotterdam the Netherlands
| | - Lukasz Sedek
- Department of Paediatric Haematology and Oncology; Zabrze Poland
- Medical University of Silesia (SUM); Katowice Poland
| | | | - Tomasz Szczepanski
- Department of Paediatric Haematology and Oncology; Zabrze Poland
- Medical University of Silesia (SUM); Katowice Poland
| | | | - Ester Mejstrikova
- Department of Paediatric Haematology and Oncology; 2nd Faculty of Medicine; Charles University (DPH/O) and University Hospital Motol; Prague Czech Republic
| | - Michaela Nováková
- Department of Paediatric Haematology and Oncology; 2nd Faculty of Medicine; Charles University (DPH/O) and University Hospital Motol; Prague Czech Republic
| | - Tomas Kalina
- Department of Paediatric Haematology and Oncology; 2nd Faculty of Medicine; Charles University (DPH/O) and University Hospital Motol; Prague Czech Republic
| | - Quentin Lecrevisse
- Cancer Research Centre (IBMCC-CSIC); Department of Medicine and Cytometry Service; University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL); Salamanca Spain
| | - Alberto Orfao
- Cancer Research Centre (IBMCC-CSIC); Department of Medicine and Cytometry Service; University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL); Salamanca Spain
| | - Arjan C. Lankester
- Department of Paediatrics; Leiden University Medical Centre; Leiden the Netherlands
| | - Jacques J. M. van Dongen
- Department of Immunology; Erasmus MC, University Medical Centre Rotterdam; Rotterdam the Netherlands
- Department of Immunohaematology and Blood Transfusion; Leiden University Medical Centre; Leiden the Netherlands
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Prognostic significance of aberrant expression of CD markers in acute lymphoblastic leukemia. MEMO - MAGAZINE OF EUROPEAN MEDICAL ONCOLOGY 2017. [DOI: 10.1007/s12254-017-0324-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cruz-Rodriguez N, Combita AL, Enciso LJ, Raney LF, Pinzon PL, Lozano OC, Campos AM, Peñaloza N, Solano J, Herrera MV, Zabaleta J, Quijano S. Prognostic stratification improvement by integrating ID1/ID3/IGJ gene expression signature and immunophenotypic profile in adult patients with B-ALL. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2017; 36:37. [PMID: 28245840 PMCID: PMC5331651 DOI: 10.1186/s13046-017-0506-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 02/21/2017] [Indexed: 01/25/2023]
Abstract
Background Survival of adults with B-Acute Lymphoblastic Leukemia requires accurate risk stratification of patients in order to provide the appropriate therapy. Contemporary techniques, using clinical and cytogenetic variables are incomplete for prognosis prediction. Methods To improve the classification of adult patients diagnosed with B-ALL into prognosis groups, two strategies were examined and combined: the expression of the ID1/ID3/IGJ gene signature by RT-PCR and the immunophenotypic profile of 19 markers proposed in the EuroFlow protocol by Flow Cytometry in bone marrow samples. Results Both techniques were correlated to stratify patients into prognostic groups. An inverse relationship between survival and expression of the three-genes signature was observed and an immunophenotypic profile associated with clinical outcome was identified. Markers CD10 and CD20 were correlated with simultaneous overexpression of ID1, ID3 and IGJ. Patients with simultaneous expression of the poor prognosis gene signature and overexpression of CD10 or CD20, had worse Event Free Survival and Overall Survival than patients who had either the poor prognosis gene expression signature or only CD20 or CD10 overexpressed. Conclusion By utilizing the combined evaluation of these two immunophenotypic markers along with the poor prognosis gene expression signature, the risk stratification can be significantly strengthened. Further studies including a large number of patients are needed to confirm these findings. Electronic supplementary material The online version of this article (doi:10.1186/s13046-017-0506-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nataly Cruz-Rodriguez
- Programa de Investigación e Innovación en Leucemias Agudas y Crónicas (PILAC), Instituto Nacional de Cancerología, Bogotá, Colombia.,Grupo de Investigación en Biología del Cáncer, Instituto Nacional de Cancerología, Bogotá, Colombia.,Programa de Doctorado en Ciencias Biológicas, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Alba L Combita
- Programa de Investigación e Innovación en Leucemias Agudas y Crónicas (PILAC), Instituto Nacional de Cancerología, Bogotá, Colombia. .,Grupo de Investigación en Biología del Cáncer, Instituto Nacional de Cancerología, Bogotá, Colombia. .,Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
| | - Leonardo J Enciso
- Programa de Investigación e Innovación en Leucemias Agudas y Crónicas (PILAC), Instituto Nacional de Cancerología, Bogotá, Colombia.,Grupo de Hemato-Oncología, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Lauren F Raney
- Department of Pediatrics, Pediatric Hematology-Oncology Louisiana State University Health Sciences Center, New Orleans, LA, USA.,Children's Hospital of New Orleans, New Orleans, LA, USA
| | - Paula L Pinzon
- Grupo de Investigación en Biología del Cáncer, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Olga C Lozano
- Grupo de Investigación en Biología del Cáncer, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Alba M Campos
- Hospital Universitario San Ignacio, Bogotá, Colombia
| | | | - Julio Solano
- Hospital Universitario San Ignacio, Bogotá, Colombia
| | | | - Jovanny Zabaleta
- Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, LA, USA.,Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Sandra Quijano
- Hospital Universitario San Ignacio, Bogotá, Colombia. .,Grupo de Inmunobiología y Biología Celular, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.
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Kim DY, Park HS, Choi EJ, Lee JH, Lee JH, Jeon M, Kang YA, Lee YS, Seol M, Cho YU, Jang S, Chi HS, Lee KH, Park CJ. Immunophenotypic markers in adult acute lymphoblastic leukemia: the prognostic significance of CD20 and TdT expression. Blood Res 2015; 50:227-34. [PMID: 26770950 PMCID: PMC4705048 DOI: 10.5045/br.2015.50.4.227] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 11/19/2015] [Accepted: 11/25/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Efforts to overcome poor outcomes in patients with adult acute lymphoblastic leukemia (ALL) have focused on combining new therapeutic agents targeting immunophenotypic markers (IPMs) with classical cytotoxic agents; therefore, it is important to evaluate the clinical significance of IPMs. METHODS Baseline characteristics and clinical outcomes of patients with adult ALL were retrospectively analyzed. The percentage of blasts expressing IPMs at diagnosis was measured by multicolor flow cytometry analysis. Samples in which ≥20% of blasts expressed an IPM were considered positive. RESULTS Among the total patient population (N=230), almost all (92%) were in first or second hematological complete remission (HCR) and 54% received allogeneic hematopoietic cell transplant (allo-HCT). Five-year hematologic relapse-free survival (HRFS) and overall survival (OS) rates were 36% and 39%, respectively, and 45.6% and 80.5% of patients were positive for the IPMs CD20 and terminal deoxynucleotidyl transferase (TdT), respectively. Expression of CD20, CD13, CD34, and TdT was associated with HRFS rate, and expression of CD20 and CD13 was associated with OS rate, as was the performance of allo-HCT. In multivariate analysis, positivity for CD20 (HRFS: hazard ratio [HR], 2.21, P<0.001; OS: HR, 1.63, P=0.015) and negativity for TdT (HRFS: HR, 2.30, P=0.001) were both significantly associated with outcomes. When patients were categorized into three subgroups according to positivity for CD20 and TdT, there were significant differences in HRFS and OS among the subgroups. CONCLUSION Positivity for CD20 and TdT expression and clinical risk group were prognostic factors in adult ALL.
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Affiliation(s)
- Dae-Young Kim
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Han-Seung Park
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun-Ji Choi
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung-Hee Lee
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Je-Hwan Lee
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mijin Jeon
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Ah Kang
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Shin Lee
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Miee Seol
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Uk Cho
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seongsoo Jang
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun-Sook Chi
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyoo-Hyung Lee
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chan-Jeoung Park
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Fogle J, Tarigo J, Thalheim L, Williams L, English L, Suter S. CD45+ and CD45− lymphocyte populations identified by flow cytometry from dogs with lymphoma exhibit similar morphology and the same clonal (B cell or T cell) lineage. Vet Immunol Immunopathol 2015; 168:242-8. [DOI: 10.1016/j.vetimm.2015.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/05/2015] [Accepted: 10/10/2015] [Indexed: 11/28/2022]
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Shahal-Zimra Y, Rotem Z, Chezar J, Oniashvili N, Leader A, Raanani P, Rabizadeh E. Adult pre B-cell acute lymphoblastic leukemia with unusually large proportion of bone marrow CD45 bright/high SSc blasts. CYTOMETRY PART B-CLINICAL CYTOMETRY 2015; 92:161-164. [PMID: 26415521 DOI: 10.1002/cyto.b.21329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 08/31/2015] [Accepted: 09/17/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND We present a pre B-ALL patient with the rare clinical manifestation of extramedullary disease, and a normal hemogram. This patient's blasts expressed bright CD45 and high side scatter (SSc) placing the cells in the monocyte gate. METHODS Samples from peripheral blood and bone marrow (BM) aspirate from a 50-year-old female patient were immunophenotyped by multiparametric flow cytometry. RESULTS Flow cytometry studies of the BM aspirate showed a large monocyte gate with 90-95% of the cells expressing an abnormal B cell phenotype. Peripheral white blood cells count was normal and cytogenetic analysis of the BM revealed a normal karyotype. CONCLUSION It was not possible, based on CD45/SSc to identify a lymphoblast population in this pre B-ALL patient. Although bright expression of CD45 B-ALL blasts has been associated with poor prognosis to the best of our knowledge, the combination of bright CD45 blasts with high SSc has not been reported. As CD45 expression vs. SSc is routinely measured in the diagnostics of acute leukemias, a possible association between CD45 bright positivity and extramedullary disease or prognosis warrants further exploration. © 2015 International Clinical Cytometry Society.
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Affiliation(s)
- Yael Shahal-Zimra
- Hematology Laboratory, Flow Cytometry Division, Hematology Institute; Tel Aviv University. Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.,Felsenstein Medical Research Center, Sackler School of Medicine, Tel Aviv University. Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Zohar Rotem
- Hematology Laboratory, Flow Cytometry Division, Hematology Institute; Tel Aviv University. Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Judith Chezar
- Hematology Laboratory, Flow Cytometry Division, Hematology Institute; Tel Aviv University. Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Nino Oniashvili
- Cytogenetic Institute; Tel Aviv University, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Avi Leader
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center Petah Tikva and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Pia Raanani
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center Petah Tikva and Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Esther Rabizadeh
- Hematology Laboratory, Flow Cytometry Division, Hematology Institute; Tel Aviv University. Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.,Cytogenetic Institute; Tel Aviv University, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel
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Loghavi S, Kutok JL, Jorgensen JL. B-acute lymphoblastic leukemia/lymphoblastic lymphoma. Am J Clin Pathol 2015; 144:393-410. [PMID: 26276770 DOI: 10.1309/ajcpan7bh5dnywzb] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES This session of the 2013 Society of Hematopathology/European Association for Haematopathology Workshop was dedicated to B-acute lymphoblastic leukemia (B-ALL)/lymphoblastic lymphoma (LBL) with recurrent translocations and not otherwise specified. METHODS In this review, we summarize the cases discussed during the workshop, review the pertinent and most recent literature on the respective topics, and provide a few key points that may aid in the workup of patients with B-ALL/LBL. RESULTS Many of the submitted cases showed interesting diagnostic, immunophenotypic, or clinical aspects of B-ALL with BCR/ABL1, MLL-associated, and other recurrent chromosomal abnormalities. Several cases showed rare aberrancies such as coexistent IGH/BCL2 and MYC rearrangements and raised issues in classification. Other cases had unusual clinical presentations, including B-ALL with hypereosinophilia and therapy-related B-ALL. Several cases highlighted the role of flow cytometry immunophenotyping in distinguishing benign B-cell precursors from aberrant lymphoblasts, and other cases raised questions regarding the clinical importance of myeloperoxidase positivity in acute lymphoblastic leukemia. CONCLUSIONS The complexity and spectrum of cases presented in this review highlight the importance of clinicopathologic correlation and the value of ancillary studies in the classification and workup of patients with B-ALL/LBL.
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Affiliation(s)
- Sanam Loghavi
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston; and
| | | | - Jeffrey L. Jorgensen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston; and
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Shaver AC, Greig BW, Mosse CA, Seegmiller AC. B-ALL minimal residual disease flow cytometry: an application of a novel method for optimization of a single-tube model. Am J Clin Pathol 2015; 143:716-24. [PMID: 25873506 DOI: 10.1309/ajcpoojravun75gd] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Optimizing a clinical flow cytometry panel can be a subjective process dependent on experience. We develop a quantitative method to make this process more rigorous and apply it to B lymphoblastic leukemia/lymphoma (B-ALL) minimal residual disease (MRD) testing. METHODS We retrospectively analyzed our existing three-tube, seven-color B-ALL MRD panel and used our novel method to develop an optimized one-tube, eight-color panel, which was tested prospectively. RESULTS The optimized one-tube, eight-color panel resulted in greater efficiency of time and resources with no loss in diagnostic power. CONCLUSIONS Constructing a flow cytometry panel using a rigorous, objective, quantitative method permits optimization and avoids problems of interdependence and redundancy in a large, multiantigen panel.
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Affiliation(s)
| | | | - Claudio A. Mosse
- Vanderbilt University Medical Center, Nashville, TN
- VA Tennessee Valley Healthcare System, Nashville
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Raponi S, Gianfelici V, Chiaretti S, Peragine N, Brugnoletti F, De Propris MS, Marinelli M, Hulselmans G, Aerts S, Geerdens E, Cools J, Foà R, Guarini A. CD45 antigen negativity in T-lineage ALL correlates withPTPRCmutation and sensitivity to a selective JAK inhibitor. Br J Haematol 2015; 171:884-7. [DOI: 10.1111/bjh.13448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Sara Raponi
- Haematology; Department of Cellular Biotechnologies and Haematology; Sapienza University; Rome Italy
| | - Valentina Gianfelici
- Haematology; Department of Cellular Biotechnologies and Haematology; Sapienza University; Rome Italy
| | - Sabina Chiaretti
- Haematology; Department of Cellular Biotechnologies and Haematology; Sapienza University; Rome Italy
| | - Nadia Peragine
- Haematology; Department of Cellular Biotechnologies and Haematology; Sapienza University; Rome Italy
| | - Fulvia Brugnoletti
- Haematology; Department of Cellular Biotechnologies and Haematology; Sapienza University; Rome Italy
| | - Maria S. De Propris
- Haematology; Department of Cellular Biotechnologies and Haematology; Sapienza University; Rome Italy
| | - Marilisa Marinelli
- Haematology; Department of Cellular Biotechnologies and Haematology; Sapienza University; Rome Italy
| | | | - Stein Aerts
- Centre for Human Genetics; KU Leuven; Leuven Belgium
| | - Ellen Geerdens
- Centre for Human Genetics; KU Leuven; Leuven Belgium
- Centre for the Biology of Disease; VIB; Leuven Belgium
| | - Jan Cools
- Centre for Human Genetics; KU Leuven; Leuven Belgium
- Centre for the Biology of Disease; VIB; Leuven Belgium
| | - Robin Foà
- Haematology; Department of Cellular Biotechnologies and Haematology; Sapienza University; Rome Italy
| | - Anna Guarini
- Haematology; Department of Cellular Biotechnologies and Haematology; Sapienza University; Rome Italy
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Alkayed K, Khattab E, Madanat F. Aberrant T-cell antigen expression in Jordanian children with B lymphoblastic leukemia. Hematol Oncol Stem Cell Ther 2015; 8:187-8. [PMID: 25784128 DOI: 10.1016/j.hemonc.2015.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 02/21/2015] [Indexed: 11/30/2022] Open
Affiliation(s)
- Khaldoun Alkayed
- Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan
| | - Eman Khattab
- Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan
| | - Faris Madanat
- Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan.
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CD5 Positive B Lymphoblastic Leukemia: Report of a Case with Review of Literature. Indian J Hematol Blood Transfus 2014; 32:1-4. [PMID: 27408342 DOI: 10.1007/s12288-014-0485-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 11/24/2014] [Indexed: 12/21/2022] Open
Abstract
We report a rare CD5 positive B cell acute lymphoblastic leukemia (B-ALL) with a review of the clinopathological features and prognosis of previously reported cases in the literature. The aberrant expression of CD 5 antigen is uncommon in B-ALL; the morphological differential diagnosis includes blastic mantle cell lymphoma, denovo CD5(+) diffuse large B cell lymphoma and secondary diffuse large cell lymphoma/Richter's transformation. CD5(+) B cell ALL is commonly reported in younger patients (<18 years). Though the expression of T cell antigens is reported to have poor prognosis, the experience with CD5(+) B-ALL is limited to draw any firm conclusion regarding its prognosis.
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Sędek Ł, Bulsa J, Sonsala A, Twardoch M, Wieczorek M, Malinowska I, Derwich K, Niedźwiecki M, Sobol-Milejska G, Kowalczyk JR, Mazur B, Szczepański T. The immunophenotypes of blast cells in B-cell precursor acute lymphoblastic leukemia: How different are they from their normal counterparts? CYTOMETRY PART B-CLINICAL CYTOMETRY 2014; 86:329-39. [DOI: 10.1002/cyto.b.21176] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 04/24/2014] [Accepted: 04/24/2014] [Indexed: 01/14/2023]
Affiliation(s)
- Ł. Sędek
- Department of Pediatric Hematology and Oncology; Medical University of Silesia; Zabrze Poland
| | - J. Bulsa
- Department of Pediatric Hematology and Oncology; Medical University of Silesia; Zabrze Poland
| | - A. Sonsala
- Department of Pediatric Hematology and Oncology; Medical University of Silesia; Zabrze Poland
| | - M. Twardoch
- Department of Pediatric Hematology and Oncology; Medical University of Silesia; Zabrze Poland
| | - M. Wieczorek
- Division of Hematology; Chorzów Center of Pediatrics and Oncology; Chorzów Poland
| | - I. Malinowska
- Department of Pediatric Hematology and Oncology; Medical University of Warsaw; Poland
| | - K. Derwich
- Department of Pediatric Hematology; Oncology and Transplantology, University of Medical Sciences; Poznań Poland
| | - M. Niedźwiecki
- Department of Pediatric Hematology; Oncology and Endocrinology, Medical University; Gdansk Poland
| | - G. Sobol-Milejska
- Department of Pediatrics; Medical University of Silesia; Katowice Poland
| | - J. R. Kowalczyk
- Department of Pediatric Hematology and Oncology; Medical University; Lublin Poland
| | - B. Mazur
- Department of Microbiology and Immunology; Medical University of Silesia; Zabrze Poland
| | - T. Szczepański
- Department of Pediatric Hematology and Oncology; Medical University of Silesia; Zabrze Poland
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Tong H, Wang H, Wang Q, Liu Z, Lu C. Immunophenotypic, Cytogenetic and Clinical Features in Chinese Adult Acute Lymphoblastic Leukaemia (ALL) Patients. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2014. [DOI: 10.47102/annals-acadmedsg.v43n3p152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: This study sought to investigate the immunophenotypic subtype profiles of 110 Chinese adult patients with acute lymphoblastic leukaemia (ALL) and its association to cytogenetics and the clinical features. Materials and Methods: A total of 110 adult patients with ALL were immunophenotyped by CD45/SSC double parameters and 4 colour flow cytometry. Seventy-three cases were also subjected to karyotype analysis by R-banding technology. The clinical and laboratory data of 110 ALL patients were retrospectively analysed. Results: Of all the patients, 21.8% were identified as T-ALL, 78.2% as B-ALL. Abnormal karyotypes were detected in 37 out of 73 (50.7%) cases and the most common cytogenetic abnormality was the Philadelphia (Ph) chromosome, which was found in 23.3% (17/73) of the cases. Myeloid antigen (MyAg) expression was documented in 47.3% of the 110 adult ALL cases analysed and CD13 was the most commonly expressed MyAg in ALL patients (32.1 %). No difference was observed in the expression of MyAg between the groups of patients with T-ALL (45.8%) and B-ALL (47.7%). Our data showed that older age, higher CD34 positivity and lower proportion of patients with splenomegaly were found to be correlated with MyAg+ ALL, and that patients with Ph+ B-ALL were older, presented with higher haemoglobin level and higher CD34 expression. No statistical difference was noted in complete remission (CR) rate, relapse rate, induction mortality or total death rate among My+ and My-, Ph+ and Ph-, or B-ALL and T-ALL patients. Conclusion: Our results indicate that the distribution of ALL in Chinese adult patients was similar with the general distribution pattern in the other countries, and the expression of MyAg in patients with T-ALL and B-ALL was comparable. Both the expression of MyAg and the presence of Ph chromosome in adult ALL were significantly associated with median age and CD34 expression while not with the response to induction treatment.
Key words: Biological characteristics, Cytogenetics, Immunophenotype
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Affiliation(s)
- Haixia Tong
- Shengjing Hospital of China Medical University, People’s Republic of China
| | - Huihan Wang
- Shengjing Hospital of China Medical University, People’s Republic of China
| | - Qiushi Wang
- Shengjing Hospital of China Medical University, People’s Republic of China
| | - Zhuogang Liu
- Shengjing Hospital of China Medical University, People’s Republic of China
| | - Chunwei Lu
- College of Public Health, China Medical University, People’s Republic of China
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Mutreja D, Pati HP, Bansal D, Sharma RK, Jain S. Aberrant Immunophenotypic Expression of CD5 in a Case of B Acute Lymphoblastic Leukemia: A Case Report. Indian J Hematol Blood Transfus 2014; 30:212-4. [PMID: 25332581 DOI: 10.1007/s12288-014-0332-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 01/09/2014] [Indexed: 11/29/2022] Open
Abstract
Aberrant expression of CD5 has rarely been reported in B cell lineage acute lymphoblastic leukemia (B-ALL). We report the rare immunophenotypic expression of CD5 in a 20-year-old male who was diagnosed to have B-ALL on bone marrow examination. Cytogenetic analysis revealed a mosaic supernumerary marker chromosome. The patient died due to acute pancreatitis after admission. CD5 positive B-ALL may represent a distinct clinicopathologic subcategory of B-ALL with an aggressive clinical course.
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Affiliation(s)
- Deepti Mutreja
- Department of Haematology, All India Institute of Medical Sciences, New Delhi, India
| | - Hara Prasad Pati
- Department of Haematology, All India Institute of Medical Sciences, New Delhi, India
| | - Divya Bansal
- Department of Haematology, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Kumar Sharma
- Department of Haematology, All India Institute of Medical Sciences, New Delhi, India
| | - Sonal Jain
- Department of Haematology, All India Institute of Medical Sciences, New Delhi, India
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46
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Abdulateef NAB, Ismail MM, Aljedani H. Clinical Significance of Co-expression of Aberrant Antigens in Acute Leukemia: A Retrospective Cohort Study in Makah Al Mukaramah, Saudi Arabia. Asian Pac J Cancer Prev 2014; 15:221-7. [DOI: 10.7314/apjcp.2014.15.1.221] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
SUMMARY Predictive/prognostic factors in acute leukemia continue to be sought, in order to refine treatment strategies. Minimal residual disease (MRD) testing has been shown to be a statistically significant factor by multivariate analysis in both acute lymphoblastic leukemia (ALL) and acute myeloid leukemia. Its utility in guiding therapy has been more extensively studied in pediatric ALL, with some protocols having instituted MRD testing into therapeutic algorithms. The clinical impact of MRD testing in ALL and acute myeloid leukemia will be presented, including both molecular and flow cytometric methodologies, with a more focused discussion of the strategy, methodology and interpretation of MRD testing by multiparametric flow cytometry.
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Affiliation(s)
- Lorinda Soma
- University of Washington, Department of Laboratory Medicine, Division of Hematopathology, Room NW120, Box 357110, 1959 NE Pacific Street, Seattle, WA 98195, USA
| | - Brent Wood
- University of Washington, Department of Laboratory Medicine, Division of Hematopathology, Room NW120, Box 357110, 1959 NE Pacific Street, Seattle, WA 98195, USA
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Zheng J, Du W, Yao J, You Y, Li W, He Y, Li X, Liu W, Wu Y, Hu Y, Jin R, Zou P, Huang S, Hu Y, Zhang M. Analysis of hematogones in bone marrow from acute myeloid leukaemia cases posttherapy. Eur J Clin Invest 2013; 43:1140-6. [PMID: 23992300 DOI: 10.1111/eci.12151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 08/03/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Increased bone marrow (BM) hematogones (HGs) are often observed in patients with marrow regenerating status. Many studies have focused on the role of HGs in acute lymphoblastic leukaemia (ALL), but very little has been done to understand their effects on acute myeloid leukaemia (AML). MATERIALS AND METHODS Through immunophenotyping, HGs were quantified in 471 BM samples from 292 postchemotherapy AML cases. These samples were analysed to determine whether there is any relationship between HGs percentages and French-American-British (FAB) subtypes or risk stratification of AML. RESULTS HGs were identified in 57.75% of 471 patient samples (271) with a mean percentage of 3.87 ± 0.25%. No significant differences were found amongst different FAB subtypes of AML (P > 0.05). However, significant differences (P < 0.05) in HG numbers were noted between AML patients experiencing haematological complete remission (HCR) and those who have relapsed. HGs were identified in 59.9% of samples under HCR with a mean per cent of 3.98 ± 0.31%, and 36.7% of individuals who have relapsed have detectable HGs with a mean per cent of 1.75 ± 0.47. In addition, HGs in patients groups with low risk or intermediate risk were elevated when compared with high-risk groups (P < 0.05), whilst no significant difference was found between low-risk patients and intermediate-risk patients (P > 0.05). Patients with >0.1% of HGs had a significantly better median leukaemia-free survival (LFS) and overall survival (OS) than those with <0.1% of HGs (P < 0.01). CONCLUSIONS Therefore, our data indicate that HGs in bone marrow may be used as a favourable prognostic factor that predict for a better outcome of AML patients.
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Affiliation(s)
- Jine Zheng
- Center for stem cell research & application, Institute of Hematology, Union Hospital, Huazhong University of Science & Technology, Wuhan, Hubei Province, China
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Rodríguez-Pardo VM, Aristizabal JA, Jaimes D, Quijano SM, de los Reyes I, Herrera MV, Solano J, Vernot JP. Mesenchymal stem cells promote leukaemic cells aberrant phenotype from B-cell acute lymphoblastic leukaemia. Hematol Oncol Stem Cell Ther 2013; 6:89-100. [PMID: 24161606 DOI: 10.1016/j.hemonc.2013.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 09/09/2013] [Accepted: 09/28/2013] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The role of bone marrow-mesenchymal stem cells (BM-MSC) in leukaemic cell control is controversial. The purpose of this work was to evaluate BM-MSC role regarding the viability, proliferation and immunophenotype of normal B-cell precursors from control (Ct) patients and leukaemic cells from B-acute lymphoblastic leukaemia (B-ALL) patients. PATIENTS AND METHODS BM-MSC were isolated and characterised from voluntary donors. Mononuclear cells isolated from Ct and B-ALL bone marrow samples were cultured in the presence or absence of BM-MSC for 7days. Cell viability was determined with LIVE/DEAD and proliferation index evaluated by CFSE labelling. Cell population immunophenotypes were characterised by estimating CD19, CD10, CD20 and CD45 antigens by flow cytometry. RESULTS After co-culture, B-ALL cells exhibited higher viability (20-40%) as compared to just cells (3-10%). Ct and B-ALL absolute cell counts were higher in the presence of BM-MSC (Ct: 25/mm(3)cf8/mm(3), B-ALL: 15/mm(3)cf3/mm(3)). Normal B-cell subpopulations in co-culture had increased expression of CD19 and CD10 (Pre-pre B) and CD45 and CD20 antigens (Pre-B). B-ALL cells co-cultured with BM-MSC showed an increase in CD19 and CD20, although the greatest increase was observed in the CD10 antigen. CONCLUSIONS Lymphoid cell maintenance, at early stages of differentiation, was significantly promoted by BM-MSC in normal and leukaemic cells. Co-cultures also modulated the expression of antigens associated with the B-ALL asynchronous phenotype as CD10 co-expressed with CD19 and CD20. To our knowledge, this is the first time that CD10, CD19 and CD20 leukaemic antigens have been reported as being regulated by BM-MSC.
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Affiliation(s)
- Viviana M Rodríguez-Pardo
- Grupo de Inmunobiología y Biología Celular, Facultad de Ciencias, Pontificia Universidad Javeriana, Cra 7(a), No. 40-62, Bogotá D.C., Colombia
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Zhou Y, Fan X, Routbort M, Cameron Yin C, Singh R, Bueso-Ramos C, Thomas DA, Milton DR, Medeiros LJ, Lin P. Absence of terminal deoxynucleotidyl transferase expression identifies a subset of high-risk adult T-lymphoblastic leukemia/lymphoma. Mod Pathol 2013; 26:1338-45. [PMID: 23702731 DOI: 10.1038/modpathol.2013.78] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 01/07/2013] [Accepted: 01/08/2013] [Indexed: 02/03/2023]
Abstract
Terminal deoxynucleotidyl transferase (TdT) can be downregulated in minimal residual disease of T-acute lymphoblastic leukemia/lymphoma (T-ALL/LBL) after chemotherapy. TdT-negative T-ALL/LBL cases are rare and have not been well characterized. We studied the clinicopathologic features of de novo T-ALL/LBL patients treated at our institution during 2003-2011, with an emphasis on immunophenotype and survival of TdT-negative versus TdT-positive cases. Absence of TdT expression was defined as <10% lymphoblasts positive. Seven (12%) TdT-negative cases were identified from a cohort of 59 de novo T-ALL/LBL. The TdT-negative and TdT-positive cases were similar with regard to gender, percentage of patients with a high leukocyte count (>100 × 10(9)/l), central nervous system involvement, and an abnormal karyotype. However, patients with TdT-negative T-ALL/LBL had a significantly higher rate of disease progression and shorter overall survival. Although not statistically significant, TdT-negative T-ALL/LBL cases were associated with an older median age and higher percentage of 'early T precursor' (ETP) immunophenotype than TdT-positive cases. Absence of TdT expression identifies a subset of high-risk T-ALL/LBL that overlaps with, but is not identical to, the ETP leukemia, providing additional prognostic value.
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Affiliation(s)
- Yi Zhou
- Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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