The immunophenotype of 325 adult acute leukemias: relationship to morphologic and molecular classification and proposal for a minimal screening program highly predictive for lineage discrimination.
Bone marrow cells of 325 adults with acute leukemia were immunophenotyped using a panel of monoclonal antibodies proposed by the European Group for the Immunological Characterization of Leukemias (EGIL). Of these, 97.2% could be assigned clearly to myeloid or lymphoid lineage (254 acute myeloid leukemias [AMLs], 48 B-cell lineage acute lymphoblastic leukemias [ALLs], 14 T-cell lineage ALLs), 1.8% as biphenotypic, and less than 1% as undifferentiated. Immunologic subtyping of ALLs revealed an association between early precursor phenotypes and coexpression of myeloid antigens, particularly CD15/CD65s coexpression and pre-pre-B cell-specific phenotypes and genotypes. The common ALL phenotype was associated with BCR-ABL translocation. Among AMLs, CD2 coexpression was almost exclusively restricted to French-American-British subtypes M3 variant and M4Eo and related molecular aberrations. The most valuable markers to differentiate between myeloperoxidase-negative AML subtypes M0 and ALLs were CD13, CD33, and CD117, typical of M0, and intracytoplasmic CD79a, intracytoplasmic CD3, CD10, and CD2, typical of B cell- or T cell-lineage ALL. Our results confirm excellent practicability of the EGIL proposalfor immunologic classification of acute leukemias. For myeloperoxidase-negative AMLs, we suggest a scoring system based on markers most valuable to distinguish between AML-M0 and ALLs.
Thalhammer-Scherrer
Renate
R
Department of Laboratory Medicine, University of Vienna, Austria.
Mitterbauer
Gerlinde
G
Simonitsch
Ingrid
I
Jaeger
Ulrich
U
Lechner
Klaus
K
Schneider
Barbara
B
Fonatsch
Christa
C
Schwarzinger
Ilse
I
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal; D015703:Antigens, CD / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D001854:Bone Marrow Cells / Q000276:immunology; D002051:Burkitt Lymphoma / Q000276:immunology; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D007938:Leukemia / Q000145:classification* / Q000276:immunology*; D015470:Leukemia, Myeloid, Acute / Q000276:immunology; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000276:immunology; D008297:Male; D008875:Middle Aged
D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D014408:Biomarkers, Tumor