Khera Rachna, Ahmed Faiq, Mundada Manasi Chetan, Devi Sandhya G, Murthy Sudha S, Lavanya Nambaru, Rajappa Senthil J, Mallavarapu Krishna Mohan, Santa A
Department of Laboratory Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India.
Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India.
Indian J Med Paediatr Oncol. 2017 Jul-Sep;38(3):266-272. doi: 10.4103/ijmpo.ijmpo_89_16.
Acute myeloid leukemia (AML) is a heterogeneous group of disorders classified as per FAB subtypes and more recently by WHO by underlying genetic abnormalities.
This study aims to analyze the morphology, immunophenotype, cytogenetic and molecular abnormalities in around 200 patients of AML diagnosed over a period of 7 years at our institute and to determine relative frequency of various subtypes (based on FAB and WHO classification). An attempt to characterize the associations between hematological parameters, immunophenotype and these subtypes was also made.
All cases diagnosed as AML on morphology, cytochemistry and/or immunophenotyping and tested for recurrent genetic abnormalities during period of Jan 2008-July 2014 were included in the study.
Age of presentation was younger in our AML patients as compared to western literature. Amongst FAB and WHO subtypes, M2 and t (15;17) PML-RARA were the most common groups respectively. As expected, CD33, CD13, were the most commonly expressed markers followed by HLA-DR, CD117, CD34 and CD14. Aberrant expression was seen in 62(41.6%) cases, most common was CD7 (15.4%), followed by CD56 (14.8%), CD19 (6.7%) and CD2 (4.7%). Significant associations between immunophenotypic markers and FAB subtypes as well as WHO subtypes were established.
This is a hospital based study, giving a detailed account of frequencies of AML subtypes, hematological parameters and immunophenotypic markers in AML patients at our institute. Being a large and one of its kind study to establish significant associations between various haematological and immunophenotypic parameters with respective AML subtypes and genetic abnormalities, it might prove to be very useful in Indian setup where facilities for cytogenetic analysis are not available in many laboratories.
急性髓系白血病（AML）是一组异质性疾病，最初根据FAB亚型分类，最近世界卫生组织（WHO）则根据潜在的基因异常进行分类。
本研究旨在分析我院在7年期间诊断的约200例AML患者的形态学、免疫表型、细胞遗传学和分子异常情况，并确定各亚型（基于FAB和WHO分类）的相对频率。同时还尝试描述血液学参数、免疫表型与这些亚型之间的关联。
本研究纳入了2008年1月至2014年7月期间所有经形态学、细胞化学和/或免疫表型诊断为AML并检测复发性基因异常的病例。
与西方文献相比，我院AML患者的发病年龄更年轻。在FAB和WHO亚型中，M2和t(15;17) PML-RARA分别是最常见的类型。正如预期的那样，CD33、CD13是最常表达的标志物，其次是HLA-DR、CD117、CD34和CD14。62例（41.6%）病例出现异常表达，最常见的是CD7（15.4%），其次是CD56（14.8%）、CD19（6.7%）和CD2（4.7%）。免疫表型标志物与FAB亚型以及WHO亚型之间建立了显著关联。
这是一项基于医院的研究，详细阐述了我院AML患者中AML亚型、血液学参数和免疫表型标志物的频率。作为一项大规模且独一无二的研究，它在各种血液学和免疫表型参数与各自的AML亚型及基因异常之间建立了显著关联，在印度的环境中可能非常有用，因为许多实验室无法进行细胞遗传学分析。
