Srishti Gupta1, Tathagata Chatterjee2, Sanjeevan Sharma3, Ajay Sharma4, Prosenjit Ganguly5, Jasjit Singh6, Satyaranjan Das7. 1. Resident (Pathology), Army Hospital (R&R), New Delhi 110010, India. 2. Commandant, 166 Military Hospital, C/o 56 APO, India. 3. Senior Adviser (Med & Hematology), Command Hospital (Southern Command), Pune 411040, India. 4. Consultant & Head (Hematology), Army Hospital (R&R), New Delhi 110010, India. 5. Senior Adviser (Pathology), Command Hospital (Eastern Command), Kolkata, India. 6. Senior Adviser (Med & Hematology), Army Hospital (R&R), New Delhi 110010, India. 7. Senior Adviser (Paediatrics & Hematology), INHS Asvini, Colaba, Mumbai, India.
Abstract
BACKGROUND: Acute myeloid leukemia and acute lymphoid leukemia differ substantially in response to therapy and course, and accurate differentiation of the two is fundamental to therapeutic decisions. Immunophenotyping is used for this purpose, and various guidelines have been proposed regarding a minimal screening antibody panel. Most of them have been found inefficient. METHODS: Eighty-two cases of consecutive acute leukemias reporting to this hospital over a period of two years were included in the study. Peripheral blood smear, bone marrow aspirate, and bone marrow biopsy were studied using morphology, cytochemical stains, and relevant immunohistochemical stains on selected biopsy specimens. Flowcytometry analysis was carried out using Indian consensus screening panel and our proposed minimal screening panel (PMSP) for comparison. RESULT: Immunophenotyping using PMSP resulted in 95.12% accurate diagnosis versus Indian consensus minimal screening panel (ICMSP) with an accuracy of 92.68%. This result was statistically significant as per Chi Square tests. CONCLUSION: PMSP can be used as a substitute for ICMSP, since it includes lineage-specific cytoplasmic antibodies, as well as lesser number of monoclonal antibodies, and enables us to diagnose mixed lineage leukemia. Fewer markers can be linked to a lower cost as well, which is relevant in a developing economy.
BACKGROUND:Acute myeloid leukemia and acute lymphoid leukemia differ substantially in response to therapy and course, and accurate differentiation of the two is fundamental to therapeutic decisions. Immunophenotyping is used for this purpose, and various guidelines have been proposed regarding a minimal screening antibody panel. Most of them have been found inefficient. METHODS: Eighty-two cases of consecutive acute leukemias reporting to this hospital over a period of two years were included in the study. Peripheral blood smear, bone marrow aspirate, and bone marrow biopsy were studied using morphology, cytochemical stains, and relevant immunohistochemical stains on selected biopsy specimens. Flowcytometry analysis was carried out using Indian consensus screening panel and our proposed minimal screening panel (PMSP) for comparison. RESULT: Immunophenotyping using PMSP resulted in 95.12% accurate diagnosis versus Indian consensus minimal screening panel (ICMSP) with an accuracy of 92.68%. This result was statistically significant as per Chi Square tests. CONCLUSION: PMSP can be used as a substitute for ICMSP, since it includes lineage-specific cytoplasmic antibodies, as well as lesser number of monoclonal antibodies, and enables us to diagnose mixed lineage leukemia. Fewer markers can be linked to a lower cost as well, which is relevant in a developing economy.
Authors: J J van Dongen; G W Krissansen; I L Wolvers-Tettero; W M Comans-Bitter; H J Adriaansen; H Hooijkaas; E R van Wering; C Terhorst Journal: Blood Date: 1988-03 Impact factor: 22.113
Authors: N Cascavilla; P Musto; G D'Arena; L Melillo; A M Carella; M P Petrilli; G Sanpaolo; M Carotenuto Journal: Haematologica Date: 1998-05 Impact factor: 9.941
Authors: R E Sobol; R Mick; I Royston; F R Davey; R R Ellison; R Newman; J Cuttner; J D Griffin; H Collins; D A Nelson Journal: N Engl J Med Date: 1987-04-30 Impact factor: 91.245