title: Diagnostic immunophenotype of acute promyelocytic leukemia before and early during therapy with all-trans retinoic acid.
abstract: OBJECTIVE
  To study the immunophenotypic changes of acute promyelocytic leukemia (APL) in patients who recently received all-trans retinoic acid (ATRA) and to assess the diagnostic utility of flow cytometry in this setting.
  
  
  METHODS
  Flow cytometry was performed on 29 newly diagnosed APLs and 93 other acute myeloid leukemias, including 25 HLA-DR- or CD34- cases. Clinical notes from referring institutions were reviewed to assess for recent ATRA administration.
  
  
  RESULTS
  Recent ATRA therapy was documented in 17 (59%) of 29 patients with APL. The main features of untreated APL were preserved with ATRA therapy, including CD34- (83% vs 82%), HLA-DR- (83% vs 100%), and CD117+ (100% vs 77%). CD11b and CD11c were negative in all untreated APLs but positive in 76% and 88% of ATRA-treated APLs, respectively. Optimal diagnostic criteria for untreated APL (CD34- or HLA-DR- and CD11b- and CD11c-) showed 100% sensitivity and 98% specificity but were not useful after ATRA administration. The best interpretative approach to ATRA-treated APL (CD34- or HLA-DR-) showed 100% sensitivity but limited specificity (73%).
  
  
  CONCLUSIONS
  Information about recent ATRA administration is critical for adequate interpretation of the flow cytometric findings in patients with suspected APL.
authors.affiliation: From the Departments of Hematopathology and Laboratory Medicine and Pedro.Horna@Moffitt.org.
authors.forename: Pedro
authors.initials: P
authors.lastname: Horna
authors.affiliation: From the Departments of Hematopathology and Laboratory Medicine and.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL.
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Sotomayor
authors.affiliation: Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Lancet
authors.affiliation: From the Departments of Hematopathology and Laboratory Medicine and.
authors.forename: Lynn C
authors.initials: LC
authors.lastname: Moscinski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000032:analysis*; D018952:Antigens, CD34 / Q000032:analysis; D000951:Antigens, Neoplasm / Q000032:analysis*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001707:Biopsy, Needle; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D005434:Flow Cytometry; D015972:Gene Expression Regulation, Neoplastic; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D016130:Immunophenotyping / Q000379:methods*; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014212:Tretinoin / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D015703:Antigens, CD; D018952:Antigens, CD34; D000951:Antigens, Neoplasm; D000970:Antineoplastic Agents; D006684:HLA-DR Antigens; D014212:Tretinoin
keywords: Acute promyelocytic leukemia; All-trans retinoic acid; Flow cytometry