Rapid diagnosis and characterization of acute promyelocytic leukaemia in routine laboratory practice.
The rapid diagnosis of the t(15;17)(q22;q21) promyelocytic leukaemia is important in the early introduction of targeted therapy with all-trans retinoic acid plus chemotherapy. It has been noted that these are usually myeloperoxidase (MPO)-positive and HLA-DR-negative with homogenous expression of CD33 and heterogeneous expression of CD13. We evaluated the use of immunophenotyping, morphology and cytogenetics in our own practice. Cascade testing, using cytoplasmic MPO expression in a high percentage of blast cells in bone marrow as the primary screen and PML (promyelocytic leukaemia protein) expression as the secondary confirmatory test, allowed rapid identification of the cases with t(15;17). This approach allows early instigation of appropriate therapy.
Lock
R J
RJ
Immunology and Immunogenetics, North Bristol NHS Trust, Southmead Hospital, Bristol, UK. robert.lock@northbristol.swest.nhs.uk
Virgo
P F
PF
Kitchen
C
C
Evely
R S
RS
D000328:Adult; D015703:Antigens, CD / Q000276:immunology*; D015214:Antigens, Differentiation, Myelomonocytic / Q000276:immunology*; D001853:Bone Marrow / Q000276:immunology; D018826:CD13 Antigens / Q000276:immunology*; D002648:Child; D002884:Chromosomes, Human, Pair 15 / Q000235:genetics; D002886:Chromosomes, Human, Pair 17 / Q000235:genetics; D005260:Female; D006684:HLA-DR Antigens / Q000276:immunology*; D006801:Humans; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology*; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D009363:Neoplasm Proteins / Q000276:immunology*; D009687:Nuclear Proteins / Q000276:immunology*; D009195:Peroxidase / Q000276:immunology*; D000071156:Promyelocytic Leukemia Protein; D063268:Sialic Acid Binding Ig-like Lectin 3; D014157:Transcription Factors / Q000276:immunology*; D014178:Translocation, Genetic / Q000235:genetics; D025521:Tumor Suppressor Proteins
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; C571163:CD33 protein, human; D006684:HLA-DR Antigens; D009363:Neoplasm Proteins; D009687:Nuclear Proteins; D000071156:Promyelocytic Leukemia Protein; D063268:Sialic Acid Binding Ig-like Lectin 3; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins; C070576:PML protein, human; D009195:Peroxidase; D018826:CD13 Antigens