Aberrant phenotypes in acute myeloid leukemia in India

Authors

  • Suresh Kumar Aparna Institute of Internal Medicine, Madras Medical College, The Tamil Nadu Dr. MGR Medical University, Tamil Nadu, India
  • Murugesan Sharmila Institute of Internal Medicine, Madras Medical College, The Tamil Nadu Dr. MGR Medical University, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20181069

Keywords:

Aberrant phenotypes, Acute myeloid leukemia, Flow cytometry

Abstract

Background: Acute myeloid leukemia (AML) is a heterogeneous disease, associated with a high diversity of phenotypes. The study was done with the aim to study about the aberrant phenotypes in acute myeloid leukemia cases and the correlation among the aberrant phenotypes and poor prognostic factors in acute myeloid leukemia.

Methods: This cross sectional study was conducted on 35 cases of newly diagnosed AML according to the selection criteria at Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai for a period of 6 months. Immunophenotyping analysis by flow cytometry was done on fresh bone marrow aspirate or peripheral blood sample by applying Acute Leukemia Panel. The co-expression of different antigen markers on lymphocytes was analyzed.

Results: Aberrant lymphoid markers were seen in 17 (49%) cases. 5 (14%) cases had lymphoid associated antigen expression alone. 3 (8%) cases had asynchronous antigen expression alone. 9 (27%) cases had both asynchronous antigen expression and lymphoid associated antigen expression which is of cases . In total, lymphoid associated antigen expression is seen in 41% of cases and asynchronous antigen expression in 35% of cases. CD3, CD19 (lymphoid associated antigen) and CD34+ CD15+ (asynchronous aberrant phenotype) were the most common equally expressed aberrant phenotypes, each in 7 cases. CD 3 was significantly more common in males (P=0.021) but in general there were no statistically significant association between adverse prognostic factors and aberrant phenotypic AML.

Conclusions: CD19 and CD3 were the most commonly expressed lymphoid associated antigen. Most common asynchronous aberrant phenotype was CD34+CD15+. None of the aberrant phenotypic expression was not associated with poor risk factors in acute myeloid leukemia except for common expression of CD3 in males.

References

Sarma A, Hazarika M, Das D, Kumar Rai A, Sharma JD, Bhuyan C, et al. Expression of aberrant CD markers in acute leukemia: a study of 100 cases with immunophenotyping by multiparameter flowcytometry. Cancer Biomark. 2015;15(4):501-5.

Saultz JN, Garzon R. Acute Myeloid Leukemia: A Concise Review. J Clin Med. 2016;5(3):33.

Gert Ossenkoppele, Arjan A van de Loosdrecht, Gerrit Jan Schuurhuis. eview of the relevance of aberrant antigen expression by flow cytometry in myeloid neoplasms. British J Haematol.2011;153(4):421-36.

Chatterjee T, Mallhi RS, Venkatesan S. Minimal residual disease detection using flow cytometry: Applications in acute leukemia. Med J Armed Forces India. 2016;72(2):152-6.

Conter V, Bartram CR, Valsecchi MG. Molecular response to treatment redefines all prognostic factors in children and adolescents with B-cell precursor acute lymphoblasticleukemia: results in 3184 patients of the AIEOP-BFM ALL 2000 study. Blood. 2010;115(16):3206-214.

El-Sissy AH, El-Mashari MA, Bassuni WY, El-Swaayed AF. Aberrant Lymphoid Antigen Expression in Acute Myeloid Leukemia in Saudi Arabia.J Egyptian Nat Cancer Inst. 2006;18(3):244-9.

Bahia DM, Yamanmoto M, Chauffaille ML, Kimura EY, Bordin JO, Fliqueiras A, et al. Aberrant phenotypes in acute myeloid leukemia: A high frequency and its clinical significance. Hematologica. 2001;86:801-6.

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(1):221-7.

Jahedi M, Shamsasenjan K, Sanaat Z, Aliparasti M, Almasi S, Mohamadian M. Aberrant Phenotype in Iranian Patients with Acute Myeloid Leukemia Advanced Pharmaceutical Bulletin. 2014;4(1):43-7.

Bhushan B,Chauhan PS, Saluja S,Verma S, Mishra AK, Siddiqui S, et al. Aberrant phenotypes in childhood and adult acute leukemia and its association with adverse prognostic factors and clinical outcome. Clin Exp Med. 2010;10:33-40.

Jha R, Grover G, Bose P.Lymphoid associated antigen expression in new cases of Acute Myeloid Leukemia. J Pathol Nepal. 2013;3:487-90.

Chang H, Yeung J, Brandwein J, Yi Q. CD7 expression predicts poor disease free survival and post-remission survival in patients with acute myeloid leukemia and normal karyotype. Leukemia Res. 2007;31:157-62.

Haase D, Feuring-Buske M, Schefer C, Schoch C, et al. Cytogenetic analysis of CD34+ subpopulations in AML andMDS characterized by the expression of CD38 and CD117. Leukemia. 1997;11674-9.

Wells SJ, Bray RA, Stempora LL, Farhi DC. CD117/CD34 expression in leukemic blasts. Am J Clin Pathol. 1996;106:192-5.

Noronha EP, Marinho HT, Thomaz EBAF, Silva CA, Veras GLR, Oliveira RAG. Immunophenotypic characterization of acute leukemia at a public oncology reference center in Maranhão, northeastern Brazil. Sao Paulo Medical J. 2011;129(6):392-401.

Putti MC, Rondelli R, Cocito MG, Aricó M, Sainati L, Conter V, et al. Expression of myeloid markers lacks prognostic impact in children treated for acute lymphoblastic leukemia: Italian experience in AIEOP-ALL 88-91 studies. Blood. 1998;92(3):795-801.

Pui CH, Behm FG, Singh B, Rivera GK, Schell MJ, Roberts WM, et al. Myeloid-associated antigen expression lacks prognostic value in childhood acute lymphoblastic leukemia treated with intensive multiagent chemotherapy. Blood. 1990;75(1):198-202.

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Published

2018-03-21

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Original Research Articles