Marian A Rollins-Raval1, Christine G Roth. 1. Division of Hematopathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Abstract
AIMS: In the absence of adequate aspirate films and touch imprints, distinction of chronic myelomonocytic leukaemia (CMML) from acute myeloid leukaemia with monocytic differentiation (Mo-AML) may be difficult solely on the basis of bone marrow biopsy morphological features. The aim of this study was to evaluate the diagnostic utility of a novel immunohistochemical panel for the diagnosis of acute and chronic myelomonocytic leukaemias in bone marrow biopsies. METHODS AND RESULTS: Immunohistochemical labelling for CD14, CD123, CD33, myeloperoxidase (MPO) and CD68R was assessed in 49 myeloid neoplasms with monocytic differentiation (24 CMMLs and 25 Mo-AMLs) and compared with that of 15 non-monocytic acute myeloid leukaemias (NM-AMLs) and 17 non-neoplastic controls. More than 20% CD14 immunohistochemistry (IHC)+ cells were seen only in Mo-AMLs and CMMLs, although Mo-AMLs showed wide variability and overlapped with other categories. More than 20% CD68R IHC+ cells had the highest sensitivity and specificity for Mo-AML. Discrepant MPO-/CD33+ expression was specific for Mo-AML but insensitive. A subset of blasts in Mo-AMLs and NM-AMLs were weakly CD123+. CONCLUSIONS: A significantly increased number of CD14+ cells raises the possibility of a myelomonocytic neoplasm but does not distinguish between CMML and Mo-AML. Significantly increased numbers of CD68R IHC+ cells and a discrepant MPO-/CD33+ staining pattern are specific for Mo-AML but are best utilized in a comprehensive panel.
AIMS: In the absence of adequate aspirate films and touch imprints, distinction of chronic myelomonocytic leukaemia (CMML) from acute myeloid leukaemia with monocytic differentiation (Mo-AML) may be difficult solely on the basis of bone marrow biopsy morphological features. The aim of this study was to evaluate the diagnostic utility of a novel immunohistochemical panel for the diagnosis of acute and chronic myelomonocytic leukaemias in bone marrow biopsies. METHODS AND RESULTS: Immunohistochemical labelling for CD14, CD123, CD33, myeloperoxidase (MPO) and CD68R was assessed in 49 myeloid neoplasms with monocytic differentiation (24 CMMLs and 25 Mo-AMLs) and compared with that of 15 non-monocytic acute myeloid leukaemias (NM-AMLs) and 17 non-neoplastic controls. More than 20% CD14 immunohistochemistry (IHC)+ cells were seen only in Mo-AMLs and CMMLs, although Mo-AMLs showed wide variability and overlapped with other categories. More than 20% CD68R IHC+ cells had the highest sensitivity and specificity for Mo-AML. Discrepant MPO-/CD33+ expression was specific for Mo-AML but insensitive. A subset of blasts in Mo-AMLs and NM-AMLs were weakly CD123+. CONCLUSIONS: A significantly increased number of CD14+ cells raises the possibility of a myelomonocytic neoplasm but does not distinguish between CMML and Mo-AML. Significantly increased numbers of CD68R IHC+ cells and a discrepant MPO-/CD33+ staining pattern are specific for Mo-AML but are best utilized in a comprehensive panel.
Authors: Ana Griciuc; Alberto Serrano-Pozo; Antonio R Parrado; Andrea N Lesinski; Caroline N Asselin; Kristina Mullin; Basavaraj Hooli; Se Hoon Choi; Bradley T Hyman; Rudolph E Tanzi Journal: Neuron Date: 2013-04-25 Impact factor: 17.173
Authors: Prateek Pophali; Pedro Horna; Terra L Lasho; Christy M Finke; Rhett P Ketterling; Naseema Gangat; David Nagorney; Ayalew Tefferi; Mrinal M Patnaik Journal: Am J Hematol Date: 2018-10-05 Impact factor: 10.047