Diagnostic criteria for minimally differentiated acute myeloid leukemia (AML-M0). Evaluation and a proposal.
We studied immunophenotypic features of 30 cases of minimally differentiated acute myeloid leukemia (AML-M0) using multiparameter flow cytometry and immunohistochemistry and evaluated the immunophenotypic features of previously reported cases to facilitate correct identification of myeloid lineage. All but 1 of our 30 cases expressed CD13 and/or CD33; 2 expressed CD19; 1 expressed CD10; none expressed both CD10 and CD19. Eleven of 30 cases expressed T-cell-associated antigens. All but 2 cases expressed CD34 and/or HLA-DR. Twelve of 27 cases expressed terminal deoxynucleotidyl transferase. Myeloperoxidase (MPO) expression was seen in 22 of 22 cases by immunohistochemistry and 1 of 4 by flow cytometry. None of 27 cases expressed cyCD3 and cyCD79a. We propose following modified criteria for AML-M0: (1) standard criteria for acute leukemia; (2) undetectable or less than 3% MPO or Sudan black B staining in blasts; (3) lack of expression of lymphoid-specific antigens, cyCD3 for T lineage and cyCD79 and cyCD22 for B lineage; and (4) positivity for any of the myelomonocytic lineage antigens known not to be expressed on normal T or B lymphocytes or positivity for MPO as detected by ultrastructural cytochemistry, immunohistochemistry, or flow cytometry.
Kaleem
Z
Z
Washington University School of Medicine, Dept of Pathology and Immunology, Division of Surgical Pathology, Box 8118, 660 S Euclid Ave, St Louis, MO 63110, USA.
White
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G
D000293:Adolescent; D000328:Adult; D000368:Aged; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D002648:Child; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000145:classification* / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000378:metabolism
D015214:Antigens, Differentiation, Myelomonocytic; D009195:Peroxidase