Ceni-Silva Vitória, Pagnano Kátia, Duarte Gislaine, Pellegrini Marina, Duarte Bruno, Metze Konradin, Lorand-Metze Irene
Hematology and Hemotherapy Center, University of Campinas, Campinas 13083-878, Brazil.
Department of Pathology, Faculty of Medical Sciences, University of Campinas, Campinas 13083-970, Brazil.
Diagnostics (Basel). 2021 Oct 26;11(11):1988. doi: 10.3390/diagnostics11111988.
(1) Background: Acute promyelocytic leukemia is curable, but bleeding complications still provoke a high early mortality. Therefore, a fast diagnosis is needed for timely starting treatment. We developed a diagnostic algorithm using flow cytometric features for discrimination between acute promyelocytic leukemia (APL) and other types of acute myeloid leukemias (AML). (2) Methods: we analyzed newly diagnosed AMLs where immunophenotyping was performed at diagnosis by an 8-color protocol. The mean fluorescence intensity (MFI) of each antigen used was assessed, and those best separating APL from other types of AML were obtained by a discriminant analysis. Phenotypic characteristics of myeloblasts of normal bone marrow were used as controls. (3) Results: 24 cases of APL and 56 cases of other primary AMLs entered the study. Among non-APL AMLs, 4 had fms-related tyrosine kinase 3 gene internal tandem duplications (FLT3-ITD) mutation, 2 had nucleophosmin (NPM1) and 10 had both mutations. SSC ( < 0.0001), HLA-DR ( < 0.0001), CD13 ( = 0.001), CD64 ( = 0.004) and CD33 ( = 0.002) were differentially expressed, but this was not the case for CD34 (50% of non-APLs had a low expression). In the discriminant analysis, the best differentiation was achieved with SSC and HLA-DR discriminating 91.25% of the patients. (4) Conclusion: MFC could differentiate APL from non-APL AML in the majority of the cases.
(1) 背景：急性早幼粒细胞白血病是可治愈的，但出血并发症仍导致较高的早期死亡率。因此，需要快速诊断以便及时开始治疗。我们开发了一种利用流式细胞术特征来区分急性早幼粒细胞白血病（APL）和其他类型急性髓系白血病（AML）的诊断算法。(2) 方法：我们分析了新诊断的AML病例，这些病例在诊断时通过8色方案进行免疫表型分析。评估所使用的每种抗原的平均荧光强度（MFI），并通过判别分析获得最能将APL与其他类型AML区分开的抗原。正常骨髓原始粒细胞的表型特征用作对照。(3) 结果：24例APL和56例其他原发性AML病例进入研究。在非APL AML中，4例有fms相关酪氨酸激酶3基因内部串联重复（FLT3-ITD）突变，2例有核仁磷酸蛋白（NPM1）突变，10例两者均有突变。SSC（<0.0001）、HLA-DR（<0.0001）、CD13（=0.001）、CD64（=0.004）和CD33（=0.002）存在差异表达，但CD34并非如此（50%的非APL表达较低）。在判别分析中，SSC和HLA-DR对91.25%的患者实现了最佳区分。(4) 结论：在大多数情况下，MFC能够区分APL和非APL AML。
