Irina Demina1, Elena Zerkalenkova1, Olga Illarionova1, Yulia Olshanskaya1, Tatiana Verzhbitskaya2,3, Alexandra Semchenkova1, Grigory Tsaur2,3,4, Ekaterina Rusanova5, Margarita Belogurova6, Ludmila Baidun7, Svetlana Plyasunova1, Tatiana Konyuhova1, Anna Kazakova1, Larisa Fechina2,3, Galina Novichkova1, Elena Samochatova1, Natalia Myakova1, Alexey Maschan1, Alexander M Popov8. 1. Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, 1 Samory Mashela St., GSP-7, Moscow, 117997, Russia. 2. Sverdlovsk Regional Clinical Children's Hospital No 1, 32 Serafimy Deryabinoy St., Ekaterinburg, 620149, Russia. 3. Research Institute of Medical Cell Technologies, 22a Karla Marksa St., Ekaterinburg, 620026, Russia. 4. Federal State Autonomous Educational Institution of Higher Education Ural Federal University named after the first President of Russia B.N.Yeltsin, 19 Mira Street, Ekaterinburg, 620002, Russia. 5. I.P. Pavlov First Saint Petersburg State Medical University, 6-8 L'va Tolstogo St., Saint Petersburg, 197022, Russia. 6. St. Petersburg Clinical Scientific and Practical Center of Specialized Medical Assistance (Oncological), 68a Leningradskaya St., Pesochnyi, Saint Petersburg, 197758, Russia. 7. Russian Children Clinical Hospital, Ministry of Health of Russia, 117 Leninskiy Prospect, Moscow, 119571, Russia. 8. Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, 1 Samory Mashela St., GSP-7, Moscow, 117997, Russia. uralcytometry@gmail.com.
Abstract
BACKGROUND: Flow cytometry (FCM) plays a crucial role in the differential diagnosis of Burkitt lymphoma/leukemia (BL) and B-cell precursor acute lymphoblastic leukemia (BCP-ALL). The presence of surface IgM (sIgM) alone or with light chain restriction indicates a mature blast phenotype (BIV by EGIL) and is usually observed in BL. However, sIgM expression could also be detected in transitional BCP-ALL cases. These similarities in immunophenotype and ambiguous correspondence with other laboratory findings may challenge the correct BL diagnostics. METHODS: We retrospectively reviewed the available data from immunophenotypic, morphological, cytogenetic, and molecular genetic studies of 146 children (85 boys and 61 girls) with a median age of 10 years (range 0-18 years) who were diagnosed with BL and BCP-ALL. The blasts' immunophenotype was studied by multicolor FCM. The conventional cytogenetic analysis included G-banded karyotyping and fluorescence in situ hybridization (FISH). RESULTS: In 54 children classified as BIV-ALL according to the EGIL, it was demonstrated that sIgM in a minority of cases can be associated with various types of BCP-ALL. Analysis of the antigen expression profile of 105 patients with verified BL (n = 21) and BCP-ALL (n = 84) showed significant differences in BL and the sIgM(+) vs BCP-ALL immunophenotype. Thus, even in cases of ambiguous sIgM expression, these two diseases could be reliably discriminated by complex immunophenotyping. Moreover, 10 patients (7 boys and 3 girls) with BL leukemic cells did not express sIgM, and they were diagnosed with BL on the basis of other laboratory and clinical signs. CONCLUSIONS: In conclusion, our study shows that BIV subtype is heterogeneous group of leukemia including not only the BL, but also BCP-ALL. In ambiguous cases, only a combination of multiple immunophenotypic, cytomorphologic, and genetic diagnostic technologies can allow the precise discrimination of BL and BCP-ALL and selection of the appropriate treatment scheme.
BACKGROUND: Flow cytometry (FCM) plays a crucial role in the differential diagnosis of Burkitt lymphoma/leukemia (BL) and B-cell precursor acute lymphoblastic leukemia (BCP-ALL). The presence of surface IgM (sIgM) alone or with light chain restriction indicates a mature blast phenotype (BIV by EGIL) and is usually observed in BL. However, sIgM expression could also be detected in transitional BCP-ALL cases. These similarities in immunophenotype and ambiguous correspondence with other laboratory findings may challenge the correct BL diagnostics. METHODS: We retrospectively reviewed the available data from immunophenotypic, morphological, cytogenetic, and molecular genetic studies of 146 children (85 boys and 61 girls) with a median age of 10 years (range 0-18 years) who were diagnosed with BL and BCP-ALL. The blasts' immunophenotype was studied by multicolor FCM. The conventional cytogenetic analysis included G-banded karyotyping and fluorescence in situ hybridization (FISH). RESULTS: In 54 children classified as BIV-ALL according to the EGIL, it was demonstrated that sIgM in a minority of cases can be associated with various types of BCP-ALL. Analysis of the antigen expression profile of 105 patients with verified BL (n = 21) and BCP-ALL (n = 84) showed significant differences in BL and the sIgM(+) vs BCP-ALL immunophenotype. Thus, even in cases of ambiguous sIgM expression, these two diseases could be reliably discriminated by complex immunophenotyping. Moreover, 10 patients (7 boys and 3 girls) with BL leukemic cells did not express sIgM, and they were diagnosed with BL on the basis of other laboratory and clinical signs. CONCLUSIONS: In conclusion, our study shows that BIV subtype is heterogeneous group of leukemia including not only the BL, but also BCP-ALL. In ambiguous cases, only a combination of multiple immunophenotypic, cytomorphologic, and genetic diagnostic technologies can allow the precise discrimination of BL and BCP-ALL and selection of the appropriate treatment scheme.
Authors: Lawrence Tsao; Hediya Y Draoua; Ifeyinwa Osunkwo; Subhadra V Nandula; Vundavalli V S Murty; Mahesh Mansukhani; Govind Bhagat; Bachir Alobeid Journal: Mod Pathol Date: 2004-07 Impact factor: 7.842
Authors: Michael N Dworzak; Barbara Buldini; Giuseppe Gaipa; Richard Ratei; Ondrej Hrusak; Drorit Luria; Eti Rosenthal; Jean-Pierre Bourquin; Mary Sartor; Angela Schumich; Leonid Karawajew; Ester Mejstrikova; Oscar Maglia; Georg Mann; Wolf-Dieter Ludwig; Andrea Biondi; Martin Schrappe; Giuseppe Basso Journal: Cytometry B Clin Cytom Date: 2017-02-21 Impact factor: 3.058
Authors: N Blin; F Méchinaud; P Talmant; R Garand; P Boutard; N Dastugue; E A McIntyre; J L Harousseau; H Avet-Loiseau Journal: Leukemia Date: 2007-11-15 Impact factor: 11.528