Background: Flow cytometry is an invaluable tool in the diagnostic evaluation of acute leukemia and post therapy monitoring; however, majority of Filipino population cannot afford the cost. The use of a minimal screening panel which is both cost-effective and provides an accurate diagnosis of acute lymphoblastic leukemia is seen as an alternative. Objectives: We aim to determine the cost-effectiveness and accuracy of using a minimal screening panel for the diagnosis of acute lymphoblastic leukemia (ALL). Methodology: We selected a limited panel of 9 antibodies comprising of CD45/CD19/CD20/CD10/HLA-DR/CD34/cCD3/cCD79a/cTdt and retrospectively reviewed newly diagnosed cases of B-cell and T-cell ALL from September 2016 to December 2019 using this panel. Results: Out of 719 bone marrow aspirates submitted for basic leukemia flow cytometric analysis we identified 268 ALL cases (239 B-ALL and 29 T-ALL). In all cases, a diagnosis was established using the limited panel. Compared to the current cost of our comprehensive panel (₱ 9,903.60). This limited panel cost ₱ 3,062.29, that offers a 69.08% savings per test, which translated to a ₱1.2 million savings a year (for an average of 180 annual cases). Conclusion: We underscore the utility of a limited panel for the diagnosis of ALL. Although this panel remains to be assessed with a larger validation cohort, its application in resource-limited developing countries is diagnostically useful and cost-effective. Recommendation The use of a limited panel of 9 antibodies is recommended as a screening panel for patients who are highly suspected of having ALL both clinically and initial bone marrow smear assessment.
Precursor Cell Lymphoblastic Leukemia-Lymphoma

RUNX1::RUNX1T1 is a core-binding factor driving fusion gene which arises from t(8;21)(q22;q22). It is one of the most common chromosomal rearrangements in both pediatric and adult Acute Myeloid Leukemia (AML) with a reported incidence o 15% in children and young adults. There are few case reports documenting RUNX1::RUNX1T1 translocation in pediatric AML. Although this is generally associated with a favorable prognosis, we report two (2) cases of de novo pediatric AML in the Philippines harboring a RUNX1::RUNX1T1 translocation, one eventually relapsed while the other attained remission but succumbed to sepsis.
Next Generation Sequencing ; RUNX1::RUNX1T1 fusion