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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: 13] [Impact Index Per Article: 2.6] [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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