Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
J Clin Pathol. 2018 Dec;71(12):1051-1059. doi: 10.1136/jclinpath-2018-205348. Epub 2018 Aug 31.
Cytogenetic and molecular aberrations are the strongest factors in determining outcome in acute myeloid leukaemia (AML). AML with complex karyotype confers a particularly poor prognosis and is associated with morphologic dysplasia. Flow cytometric immunophenotyping (FCI) has been investigated in defining dysplasia within myelodysplastic syndromes, but little is known about immunophenotypic dysplasia in AML and correlation with genetic abnormalities. This study aimed to explore differences in antigen expression by FCI in AML with complex karyotype (AML-CK) and AML with complex karyotype and mutations (AML-TP53) compared with AML with normal karyotype (AML-NK).
Twenty-five cases of AML-CK, 13 of which had abnormalities of , were compared with 83 cases of AML-NK using FCI.
Our findings demonstrated brighter expression of CD34 with decreased CD33 and aberrant expression of CD5 in blasts of AML-CK, while AML-TP53 blasts exhibited brighter expression of CD13. Granulocytes in AML-CK exhibited brighter expression of CD5, CD7, CD10 and CD14, with brighter CD3 also seen in AML-TP53.
Our results suggest that immunophenotypic dysplasia correlates with complex karyotype and mutation, including increased expression of T-cell antigens.
细胞遗传学和分子异常是决定急性髓系白血病（AML）预后的最强因素。具有复杂核型的 AML 预后特别差，且与形态学发育不良有关。流式细胞术免疫表型（FCI）已被用于在骨髓增生异常综合征中定义发育不良，但对于 AML 中的免疫表型发育不良及其与遗传异常的相关性知之甚少。本研究旨在探索具有复杂核型的 AML（AML-CK）和具有复杂核型和 突变的 AML（AML-TP53）与具有正常核型的 AML（AML-NK）相比，FCI 中抗原表达的差异。
使用 FCI 比较了 25 例 AML-CK（其中 13 例存在 异常）和 83 例 AML-NK。
我们的研究结果表明，AML-CK 中的原始细胞 CD34 表达更亮，CD33 表达减少，CD5 表达异常，而 AML-TP53 中的原始细胞 CD13 表达更亮。AML-CK 中的粒细胞表现为 CD5、CD7、CD10 和 CD14 的表达更亮，CD3 的表达也更亮，而 AML-TP53 中的粒细胞表现为 CD3 的表达更亮。
我们的结果表明，免疫表型发育不良与复杂核型和 突变相关，包括 T 细胞抗原表达增加。
