Flow cytometric analysis of Mixed phenotype acute leukemia: Experience from a tertiary oncology center.
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Date
2015-04
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Abstract
Introduction: Mixed phenotype acute leukemia (MPAL) is a rare subset of
acute leukemia where the blasts exhibit lineage specifi c antigens of more
than one lineage. Flow cytometric immunophenotyping is essential for the
diagnosis of MPAL and the accurate diagnosis highly depends on the panel
of markers used. The precise incidence of MPAL is uncertain as various
institutions use different combinations of antibodies to assign the blasts to
a particular lineage. Aim: The aim was to study the immunoprofi le of acute
leukemia including aberrant antigen expressions and to study the incidence,
clinical features, laboratory fi ndings, and immunophenotype of MPAL in our
institution. Materials and Methods: All cases of acute leukemias in which
fl ow cytometric analysis during 1-year period from July 2012 to July 2013
were included in this study. Results: During the study period, fl ow cytometric
analysis of 506 cases was performed. B lymphoblastic leukemia was the
most common subtype of acute leukemia. CD13 was the most common
aberrant antigen expression in acute lymphoblastic leukemia and CD7 was
the most common aberrant antigen expression in acute myeloid leukemia.
A diagnosis of MPAL was made in 15 cases, which accounted for 2.96% of
all leukemias. 9 cases were diagnosed as T/myeloid, 5 cases as B/myeloid
and 1 case as B/T. Conclusion: Mixed phenotype acute leukemia is a rare
subset of acute leukemia. Flow cytometry is critical in establishing a diagnosis
of MPAL. The panel of antibodies used is important in the identifi cation of
the “mixed” phenotype. Cytoplasmic markers (cytoplasmic MPO, cytoplasmic
79a, cytoplasmic 22 and cytoplasmic CD3) should be included in the primary
flow cytometric panel.
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Keywords
Aberrant antigen expression, flow cytometry, mixed phenotype acute leukemia
Citation
Sukumaran Renu, Nair Rekha A, Jacob Priya Mary, Anila Kunjulekshmi Amma Raveendran Nair, Prem Shruthy, Binitha Rajeswary, Kusumakumary Parukuttyamma. Flow cytometric analysis of Mixed phenotype acute leukemia: Experience from a tertiary oncology center. Indian Journal of Pathology & Microbiology. 2015 Apr-Jun 58(2): 181-186.