Immunophenotypic aberrancy in acute leukemia – a retrospective single institute study
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Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Pathology Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Submission date: 2020-03-04
Final revision date: 2020-10-16
Acceptance date: 2020-10-16
Online publication date: 2021-05-13
Corresponding author
Pardis Nematollahi   

Isfahan University of Medical Science
Pol. Ann. Med. 2021;28(2):107-111
In 2016, WHO gave a comprehensive classification system that included morphology, immunophenotyping, molecular and genetic findings. Flow cytometric immunophenotyping is the backbone of WHO classification, helping to make a more accurate and faster diagnosis.

This study has been conducted to find immunophenotyping aberrancy of acute leukemia (AL) and its association with gender and age group.

Material and methods:
This is a descriptive retrospective study of 1012 AL patients diagnosed between January 2011 and January 2019, including all new patients of all ages and both sexes, who had available immunophenotyping data.

Results and discussion:
The most common aberrant antigen on acute myeloid leukemia (AML) was CD7, on precursor B lymphoblastic leukemia (B-ALL) was CD33 and on precursor T lymphoblastic leukemia (T-ALL) was CD13. There was no association between sex/age and antigen aberrancy except a significant increase in CD34 loss on pre B acute lymphoblastic leukemia (pre B-ALL) and HLA-DR expression on acute promyelocytic leukemia (APL) in males compared to female patients and an increase of CD19 expression on non-APL-AML and an elevation of CD34 loss on T-ALL in adult compared to pediatric patients. Not only detection of aberrant expression of CD markers in leukemic cells helps to estimate molecular abnormalities and has a prognostic effect, but also a specification of neoplastic cell markers at the time of diagnosis is essential for monitoring patients after treatment.

Although in this study, no association between sex/age and aberrancy of antigens was detected (except in certain AL subtypes), AL specific immunophenotype is essential for minimal residual disease detection.

Deschler B, Lübbert M. Acute myeloid leukemia: Epidemiology and etiology. In: Faderl SH, Kantarjian HM, eds. Acute Leukemias. Berlin: Springer; 2008:47–56.
Vardiman JW, Thiele J, Arber DA, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: Rationale and important changes. Blood. 2009;114(5):937–951.
Misiukiewicz-Poć M, Poniatowska-Broniek G, Gizelbach-Żochowska K, et al. Isolated primary myeloid sarcoma of small intestine – A case report and review of the literature. Pol Ann Med. 2012;19(2):122–128.
Wartenberg D, Groves FD, Adelman AS. Acute lymphoblastic leukemia: epidemiology and etiology. In: In: Faderl SH, Kantarjian HM, eds. Acute Leukemias. Berlin: Springer; 2008:77–93.
Béné M, Nebe T, Bettelheim P, et al. Immunophenotyping of acute leukemia and lymphoproliferative disorders: a consensus proposal of the European LeukemiaNet Work Package 10. Leukemia. 2011;25(4):567–574.
Harakati MS, Al-Momen AM, Ajarim DS, et al. Adult acute myeloblastic leukemia: experience at King Khalid University Hospital. Ann Saudi Med. 1998;18(3):221–225.
Saxena R, Anand H. Flow cytometry in acute leukemia. Indian J Hematol Blood Transfus. 2008;24(4):146–150.
Bain BJ, Béné MC. Morphological and immunophenotypic clues to the WHO categories of acute myeloid leukaemia. Acta Haematol. 2019;141(4):232–244.
Albano F, Mestice A, Pannunzio A, et al. The biological characteristics of CD34+ CD2+ adult acute promyelocytic leukemia and the CD34 CD2 hypergranular (M3) and microgranular (M3v) phenotypes. Haematologica. 2006;91(3):311–316.
Kermani I. Immunophenotyping of acute leukemia in northwestern Iran. Iran J Med Sci. 2002;27(3):136–138.
Craig FE, Foon KA. Flow cytometric immunophenotyping for hematologic neoplasms. Blood. 2008;111(8):3941–3967.
Tipu HN, Muhammad MB, Altaf C, Noman M, Malik HS. Spectrum of acute leukemias and aberrant markers expression based on flowcytometry in a tertiary care centre. PAFMJ. 2018;68(3):450–454.
Seegmiller AC, Kroft SH, Karandikar NJ, McKenna RW. Characterization of immunophenotypic aberrancies in 200 cases of B acute lymphoblastic leukemia. Am J Clin Pathol. 2009;132(6):940–949.
Sharma M, Varma N, Sachdeva MUS, Bose P, Varma S. Clinical and hematological correlates of aberrant immunophenotypic profiles in adult and pediatric acute myeloid leukemia at presentation. J Cancer Res Ther. 2020;16(1):105.
Khurram MM, Jafri SA, Mannan A. Frequency of aberrant expression of CD markers in cases of acute leukemia.  Med J Islamic World Acad Sci. 2010;109(395):1–6.
Koju S, Sachdeva MUS, Bose P, Varma N. Spectrum of acute leukemias diagnosed on flow cytometry: Analysis from tertiary care centre from North India. Clin Chem Lab Med. 2015;1(1):12–15.
Sarma A, Hazarika M, Das D, 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):501–505.
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