title: Identification of NPMc+ acute myeloid leukemia in bone marrow smears.
abstract: The most frequent genetic change currently known in acute myeloid leukemia (AML) is the mutation of the nucleophosmin (NPM) gene. Aberrant cytoplasmic accumulation of NPM protein (NPMc+) is the result of this mutation, and it can be demonstrated by immunohistochemistry for the identification of a favorable subgroup within "AML with normal karyotype" according to the World Health Organization classification. NPM staining pattern was defined in 71 AML and 15 control cases by the use of bone marrow smears in order to overcome limitations observed due to immunohistochemistry. In 13/71 cases (18.3%), clear cytoplasmic staining of the leukemic blast cells was detectable that was comparable with the positivity of mitotic figures physiologically lacking nuclear membrane. The biological and genetic characteristics of the NPMc+ cases determined this way were identical with the previously published results including low CD34 and HLA-DR expression and lack of recurrent karyotype abnormalities. Bone marrow smears are well applicable and therefore a real alternative for the determination of NPM with the highest accuracy for optimal risk stratification in AML.
authors.affiliation: Department of Pathology, University of Debrecen, Debrecen, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Bedekovics
authors.forename: László
authors.initials: L
authors.lastname: Rejtő
authors.forename: Béla
authors.initials: B
authors.lastname: Telek
authors.forename: Attila
authors.initials: A
authors.lastname: Kiss
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Hevessy
authors.forename: Anikó
authors.initials: A
authors.lastname: Ujfalusi
authors.forename: Gábor
authors.initials: G
authors.lastname: Méhes
mesh_terms: D018952:Antigens, CD34 / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000276:immunology / Q000378:metabolism*; D001854:Bone Marrow Cells / Q000276:immunology / Q000378:metabolism*; D005240:Feasibility Studies; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000473:pathology; D009154:Mutation / Q000235:genetics; D009687:Nuclear Proteins / Q000235:genetics / Q000276:immunology / Q000378:metabolism*; D000090243:Nucleophosmin; D011379:Prognosis; D012680:Sensitivity and Specificity
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D006684:HLA-DR Antigens; C000716967:NPM1 protein, human; D009687:Nuclear Proteins; D000090243:Nucleophosmin