Acute leukemias with unusual immunophenotypes.
10.3346/jkms.1992.7.4.377
- Author:
Myoung Hee PARK
1
;
Yoon Sun YANG
;
Han Ik CHO
;
Byoung Kook KIM
;
Seon Yang PARK
;
Hyo Seop AHN
;
Hee Young SHIN
;
Hee Jung KANG
;
Won Il OH
;
Sang In KIM
Author Information
1. Department of Clinical Pathology, Seoul National University College of Medicine, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Acute leukemia;
Immunophenotype;
Ectopic antigen expression;
Lineage infidelity
- MeSH:
Acute Disease;
Antigens, Differentiation/blood;
Burkitt Lymphoma/immunology;
Humans;
Immunophenotyping;
Leukemia/*immunology;
Leukemia, Myeloid/immunology;
Leukemia-Lymphoma, Adult T-Cell/immunology;
Retrospective Studies
- From:Journal of Korean Medical Science
1992;7(4):377-384
- CountryRepublic of Korea
- Language:English
-
Abstract:
Over a two-year period, immunophenotypic patterns of 266 acute leukemia cases were analyzed using a panel of tests including TdT, SmIg and 9 surface antigens by the immunofluorescence stains for the assessment of the incidence and grade of phenotypic ambiguity (lineage infidelity) and the possible clinical significance of unusual immunophenotypes. Immunophenotypes were classified into four groups according to the degree of ectopic antigen expression. We classified as Group A (91.7%, 244 of 266 cases) those expressing conventional pattern without ectopic antigen. Group B (3.0%, 8 of 266 cases) was defined to have at least two lineage specific markers and single ectopic antigen. Such a "low grade deviation" did not prevent a definite immunodiagnosis. Group C (4.2%, 11 of 266 cases) revealed a promiscuous coexpression of markers related to different lineages, including two cases (0.8%, 2 cases) of biphenotypic leukemia. Group D (1.1%, 3 cases) included unclassifiable immunophenotypes with no antigen or HLA-DR only expression. Both patients with biphenotypic leukemia and one patient with unclassifiable immunophenotypes failed to respond to induction chemotherapy, suggesting a poor prognosis in these patients. The incidence of acute myelogenous leukemia (AML) cases with one or more ectopic surface antigens was 10 (8.1%) of the 124 AML cases. Ectopic antigen expression was seen in 5 (4%) of the 125 B-lineage acute lymphoblastic leukemia (ALL) cases and 3 (25%) of the 12 T-ALL cases. It is concluded that nearly 95% of cases of acute leukemia cases can be diagnosed accurately with immunophenotyping alone including patients with a mild degree of deviation from expected antigenic patterns.(ABSTRACT TRUNCATED AT 250 WORDS)
