Immunophenotypic characterization of acute leukemia at a public oncology reference center in Maranhão, northeastern Brazil

Comparison of Bone Marrow Aspiration Interpretation with Immunophenotyping in Children’s Leukemia Diagnosis

Introduction The prevalence of cancer in children is increasing. The morphological diagnosis of acute leukemia is divided into ALL and AML and is sometimes incompatible with the diagnosis of flow cytometry, which shows the characteristics of malignant cells. This study aims to compare the results of the interpretation of bone marrow aspiration with immunophenotyping in diagnosing childhood leukemia.  Methods Data from medical records was used in a retrospective cohort study of children with leukemia (ages 1–18 years) admitted to Dr. Wahidin Sudirohusodo Hospital Makassar from 2013 to 2017. All patients with a working diagnosis of leukemia were examined for bone marrow aspiration, followed by immunophenotyping, and each group was analyzed. Results Of a total of 90 study subjects, the final diagnosis based on immunophenotyping was 60 ALL and 30 AML patients with a mean age of 8 years and 3 months. The male to female ratio was 1.7:1 (p = 0.353). The mean age of the ALL group was 7 years and 10 months, and AML, 9 years (p = 0.409). The suitability of morphology and flow cytometry to ALL and AML was 92.3% and 50%, respectively. Most markers were in the ALL CD 10 and CD 20 groups with a sensitivity of 100% each, and AML CD 117 with a sensitivity of 92%. Conclusion The correspondence between the results of the interpretation of bone marrow aspiration with immunophenotyping in diagnosing ALL 92.3% and AML 50%.

Distribution of subtypes and immunophenotypic characterization of 1379 cases of paediatric acute leukaemia

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 31^st, 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.

Validation of an exercise booklet for children with acute lymphoblastic leukemia

Abstract Introduction: Leukemia is the most common childhood cancer, and acute lymphoblastic leukemia (ALL) accounts for 75 to 80% of all such cases in this population. Survival has increased among children and adolescents due to advances in diagnosis and treatment, with a growing emphasis on the need for rehabilitation to improve functionality and quality of life, mitigating the long-term effects of treatment. Objective: To describe the process of compiling and validating an exercise booklet for children and adolescents during and after treatment for acute lymphoblastic leukemia. Methods: Methodological study using the Delphi technique for validation. The panel of experts consisted of seven healthcare professionals and three mothers of children without ALL. The booklet was evaluated using a form containing 15 items scored on a 5-point Likert scale, and by qualitative assessment. The frequency of the expert ratings, percentage agreement and content validity index (CVI) were presented for each item and the instrument as a whole. Analyses were performed in R 3.5.1 software. Results: The booklet containing stretching, aerobics, strength and relaxation exercises was validated in the second round, reaching 100% consensus. When assessed only by the mothers, 93.33% consensus was achieved in a single round. Conclusion: The exercises booklet was validated for use in the population studied.

Interleukin-10 (1082G/A) Polymorphism is Associated with Susceptibility of Acute Myeloid Leukemia Patients in Sudanese Population

Background:

Interleukin-10 (IL-10) is a multifunctional cytokine with both immunosuppressive and anti-angiogenicfunctions and may have both tumor-promoting and -inhibiting properties. We examined the association between a single nucleotide polymorphism (SNP) in IL-10-1082G/A (rs1800896) in Sudanese acute myeloid leukemia (AML) patients and to assess the association between polymorphisms in IL-10 -1082G/A (rs1800896) and the hematological profile in Sudanese patients with AML.

Methods:

A total of 30 patients with acute myeloid leukemia and 30 control subjects were enrolled in this study. Blood samples were collected from all patients in EDTA containing tubes. Genomic DNA was extracted from all blood samples using salting out method. The genotypic variants of IL-10 (-1082G/A) polymorphism were detected by allele specific-PCR.

Results:

We found that (36.7%) of patients have homogenous GG genotype, (43.3%) have heterogeneous GA genotype and (20.0%) have AA genotype. GA genotype was significantly associated with higher risk of AML compared with the homozygous Genotypes (GG and AA), there is no association between IL-10 (-1082G/A) polymorphism and AML sub-type, gender, age group, mean of hematological parameters.

Conclusion:

Our study concluded that GA genotype of IL-10 -1082G/A (rs1800896) polymorphism is a risk factor for AML and G allele is insignificantly higher than A allele in AML patient. No association between IL-10 (-1082G/A) polymorphism and AML sub-type, gender, age group, mean of hematological parameters.

Evaluation of cost effective diagnostic tools in characterisation of Acute Leukemia in Southern India

The incidence of Acute Leukemia (AL) subtypes varies according to geographical distribution and more predominant in developing countries. The aim here was to evaluate the usefulness of cost effective diagnostic tools in characterization of Acute Lymphoblastic Leukemia (ALL) in resource poor population. One hundred and two AL cases were diagnosed. For diagnosis, cytochemical analysis and immunohistochemistry were performed. Among the children < 12 years, ALL was 64.3% while AML accounted for 30%. In patients > 12 years, ALL was 59.4% and AML was 31.3%. The B-ALL occurred most frequently than T-ALL in both the age groups while based on immunophenotyping in AML, CD13 was the most commonly expressed antigen. Hence, cost effective diagnostic tools namely the immunophenotyping and cytochemistry are useful and improve accuracy and rapidly risk-stratify patients that were diagnosed with acute leukemia.