Supriyadi Eddy, Widjajanto Pudjo H, Veerman Anjo J p, Purwanto Ignatius, Nency Yetty M, Gunawan Stefanus, Nafianti Selvi, Purnomosari Dewajani, Intansari Umi S, Westra Guus, Cloos Jacqueline
Department of Pediatrics, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Asian Pac J Cancer Prev. 2011;12(12):3381-7.
Immunophenotyping, as suggested by WHO, may improve diagnosis of childhood leukemia since it offers a better classification of the hematopoietic lineage of malignant cells as compared to morphology. Therefore, we aimed to determine the proportion of the immunophenotypic subtypes of acute leukemia in Indonesian children.
Samples were obtained from patients (0-14 years of age) in 4 hospitals in Indonesia. We analyzed 541 suspected leukemia samples presented over a 4-year period (March 2006 - July 2010) by flow cytometry. Immunophenotyping allowed classification into acute myeloid leukemia (AML) and ALL (B-lineage and T-lineage ALL).
Of 541 samples, 136 were tested using a single color method and 405 with a three-color method. Concordance with morphology was very good (?=0.82) using the three-color method with a panel of 15 monoclonal antibodies (n=387). A relatively high percentage of acute leukemia was classified as AML (23%). Of the ALL samples 83% were B-lineage ALL and 17% T- lineage ALL. Nine out of 239 morphological ALL were labeled AML, and 12/79 morphological AML were in fact ALL.
Immunophenotyping in a multi-center study proved feasible and appears particularly important for prognostic assessment of childhood leukemia in low income countries such as Indonesia.
世界卫生组织建议，免疫表型分析可能有助于改善儿童白血病的诊断，因为与形态学相比，它能更好地对恶性细胞的造血谱系进行分类。因此，我们旨在确定印度尼西亚儿童急性白血病免疫表型亚型的比例。
样本取自印度尼西亚4家医院的患者（0至14岁）。我们通过流式细胞术分析了在4年期间（2006年3月至2010年7月）呈现的541份疑似白血病样本。免疫表型分析可将其分类为急性髓系白血病（AML）和急性淋巴细胞白血病（ALL，B系和T系ALL）。
在541份样本中，136份采用单色法检测，405份采用三色法检测。使用包含15种单克隆抗体的三色法（n = 387）时，与形态学的一致性非常好（κ = 0.82）。相对较高比例的急性白血病被分类为AML（23%）。在ALL样本中，83%为B系ALL，17%为T系ALL。239例形态学诊断为ALL的样本中有9例被标记为AML，79例形态学诊断为AML的样本中有12例实际上是ALL。
多中心研究中的免疫表型分析证明是可行的，并且对于印度尼西亚等低收入国家的儿童白血病预后评估显得尤为重要。
