Rajkumar Namrata N, Vijay Raghavendra H
Hon Professor, Department of Haematology, KEM Hospital, Consultant Haematologist, Hinduja Hospital, Mumbai, Maharashtra.
J Assoc Physicians India. 2017 Jul;65(7):14-17.
Acute lymphoblastic leukemia (ALL) is disease of lymphoid precursors and is the most common cancer. Diagnosis of ALL is made by evaluating morphology and flowcytometric Immunophenotyping (FCI)and is an important adjunct in diagnosis and determining treatment in ALL, with availability of extensive monoclonal antibodies in the recent years there is tremendous progress in the field of FCI, and is a requirement by World Health Organisation for the classification of acute lymphoblastic Leukemia. Flow cytometric immunophenotyping of the leukemic blasts helps in categorization of acute lymphoblastic leukemia as B-ALL or T-ALL. Though ALL is the most common cancer, there is paucity of study in Indian scenario, and very few reports of immunologically subtyping of ALL is reported.
To confirm the clinical/morphological diagnosis and to determine immunological subtype of acute lymphoblastic leukemia as per requirement by World Health Organization for the classification of acute lymphoblastic leukemia.
At Kidwai State Cancer institute, Bangalore, we have performed of Immunophenotyping in 1425 untreated cases of acute leukemias during January 2012 - August 2015.
Flow cytometry analysis of 1425 cases of acute Leukemias were performed, 918 (64.42%) were acute lymphoblastic Leukemia, 688 were B-ALL (74.94%), majority(480) of B-ALL were in children (69.76%), 230 were T-ALL (25.05 %), B-ALL was the most common subtype of acute leukemias.
Acute lymphoblastic leukemia is the most common leukemia in adults and children. Immunophenotping helps in confirming the clinical/morphological diagnosis and in determining the immunological subtype of acute lymphoblastic leukemia, thus has an important role in deciding on the treatment regime. ALL is the disease of lymphoid precursors and is more common cancer in children than adults. B-ALL was the most common subtype of acute leukemias both in adults and in children. T-ALL is less common in pediatric population. Flowcytometric techniques are used to measure (submicroscopic) minimal residual disease (MRD), and is currently incorporated in many ALL treatment protocols as a tool for risk stratification.
急性淋巴细胞白血病（ALL）是一种淋巴前体细胞疾病，是最常见的癌症。ALL的诊断通过评估形态学和流式细胞免疫表型分析（FCI）来进行，这在ALL的诊断和治疗决策中是一项重要辅助手段。近年来，随着大量单克隆抗体的出现，FCI领域取得了巨大进展，这也是世界卫生组织对急性淋巴细胞白血病进行分类的要求。白血病原始细胞的流式细胞免疫表型分析有助于将急性淋巴细胞白血病分类为B-ALL或T-ALL。尽管ALL是最常见的癌症，但在印度的研究较少，关于ALL免疫亚型分类的报道也非常少。
根据世界卫生组织对急性淋巴细胞白血病分类的要求，确认急性淋巴细胞白血病的临床/形态学诊断并确定其免疫亚型。
在班加罗尔的基德瓦伊国家癌症研究所，我们于2012年1月至2015年8月期间对1425例未经治疗的急性白血病病例进行了免疫表型分析。
对1425例急性白血病病例进行了流式细胞术分析，其中918例（64.42%）为急性淋巴细胞白血病，688例为B-ALL（74.94%），大多数（480例）B-ALL患者为儿童（69.76%），230例为T-ALL（25.05%），B-ALL是急性白血病中最常见的亚型。
急性淋巴细胞白血病是成人和儿童中最常见的白血病。免疫表型分析有助于确认急性淋巴细胞白血病的临床/形态学诊断并确定其免疫亚型，因此在决定治疗方案方面具有重要作用。ALL是淋巴前体细胞疾病，在儿童中比成人中更常见。B-ALL是成人和儿童急性白血病中最常见的亚型。T-ALL在儿科人群中较少见。流式细胞术技术用于测量（亚微观）微小残留病（MRD），目前已被纳入许多ALL治疗方案中作为风险分层的工具。
