title: Flow cytometry immunophenotyping evaluation in acute lymphoblastic leukemia: correlation to factors affecting clinic outcome.
abstract: The authors conducted a flow cytometry immunophenotyping study in patients with acute lymphoblastic leukemia (ALL) from Natal, Rio Grande do Norte, Brazil. The patients (n = 126) were newly diagnosed using a panel of monoclonal antibodies: CD1a, CD2, CD3, CD4, CD7, CD8, CD10, CD13, CD33, CD14, CD19, CD22, CD79a, CD117, CD34, anti-IgM, anti-TdT, anti-HLA-Dr, and anti-human kappa and lambda light chains. Additional data, such as patients' age and gender, clinical and laboratory findings such as presence of tumor masses, lymphadenopathy, hepatomegaly, splenomegaly, leukemic infiltration in the central nervous system (CNS) were also investigated. Results showed that 56.7% of the cases were B-lineage ALL and 55% were T-cell ALL. Also, we found that males were more affected by the disease, regardless of immunological classification. The correlation between age and immunological subtypes showed that the B-lineage ALL occurred more frequently in patients aged under 15 while the T-cell ALL subtype was more frequent in adults. Immunophenotypic profiles and morphological subtypes showed a direct correlation between L3 subtype and B-lineage ALL, while L1 and L2 subtypes correlated more often with B-cell lineage and T-cell ALL, respectively. Correlation analysis between immunophenotypic and clinical profiles showed that T-cell ALL was more associated with a higher incidence of lymphadenopathy, hepatomegaly, splenomegaly and CNS leukemic infiltration, also showing a greater blast cell count in peripheral blood than the other subgroups. The presented data suggest that immunophenotyping is an important method in the diagnosis, monitoring and prognostic assessment in determining the pathological mechanisms of evolution of ALL.
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia da Universidade Federal do Rio Grande do Norte, Natal-RN, Brazil.
authors.forename: Gabriela Vasconcelos de Andrade
authors.initials: GV
authors.lastname: Alves
authors.forename: Andrea Luciana Araújo da Cunha
authors.initials: AL
authors.lastname: Fernandes
authors.forename: Juliana Mendonça
authors.initials: JM
authors.lastname: Freire
authors.forename: Aldair de Souza
authors.initials: Ade S
authors.lastname: Paiva
authors.forename: Roberto Chaves de
authors.initials: RC
authors.lastname: Vasconcelos
authors.forename: Valéria Soraya de Farias
authors.initials: VS
authors.lastname: Sales
authors.forename: Telma Maria de Araújo Moura
authors.initials: TM
authors.lastname: Lemos
authors.forename: Erica Aires
authors.initials: EA
authors.lastname: Gil
authors.forename: Flávio Henrique Miranda de Araújo
authors.initials: FH
authors.lastname: Freire
authors.forename: Dany Geraldo Kramer
authors.initials: DG
authors.lastname: Cavalcanti e Silva
authors.forename: James Farley Rafael
authors.initials: JF
authors.lastname: Maciel
authors.forename: Irian Guedes
authors.initials: IG
authors.lastname: Farkatt
authors.forename: Geraldo Barroso
authors.initials: GB
authors.lastname: Cavalcanti Júnior
mesh_terms: D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000097:blood / Q000737:chemistry / Q000145:classification; D002648:Child; D002675:Child, Preschool; D005434:Flow Cytometry / Q000379:methods; D006801:Humans; D016130:Immunophenotyping / Q000379:methods; D007223:Infant; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000145:classification* / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D015703:Antigens, CD