Venugopalan Radhika K, Singh Neha, Anthony Michael L, Kunnumbrath Arathi, Gupta Arvind K, Nath Uttam K, Chowdhury Nilotpal, Chandra Harish
Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of Medical Oncology and Hematology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
J Cancer Res Ther. 2023 Jul-Sep;19(5):1335-1339. doi: 10.4103/jcrt.jcrt_809_21.
Leukemic cells express a characteristic set of "cluster of differentiation" (CD) markers, which forms the basis of the current WHO classification. Leukemia-associated aberrant immunophenotype (LAIP) refers to expression of unusual CD markers by leukemic cells, which are not normally expressed by their respective lineage. The incidence of LAIP varies considerably, and its clinical implications, prognostic relevance, and sensitivity to therapy are still debatable. This study was conducted to identify the immunophenotypic aberrancies in newly diagnosed leukemias in our Institute.
This was an observational study, which included newly diagnosed leukemias on flow cytometry. Aberrant immunophenotypic expressions were recorded whenever present and were correlated with prognostic factors like age, gender, and total leucocyte count (TLC).
The study included 110 newly diagnosed cases of leukemias (85 acute and 25 chronic) over 1.5 years. Immunophenotypic aberrancies were detected in 40.4% of the cases. The highest incidence of aberrations was detected in acute myeloid leukemia (60.7%). LAIPs were detected in 50% of T-acute lymphoblastic leukemia and 25% cases of in B-cell acute lymphoblastic leukemia (B-ALL). Aberrant CD33 and CD56 expression in B-ALL correlated with poor prognostic factors like higher age and higher TLC, respectively. Immunophenotypic aberrancies were present in 28% cases of chronic lymphocytic leukemia.
The results of this study have generated valuable baseline data on the incidence of LAIPs in this region. This information is vital because establishing LAIPs at the time of diagnosis is crucial for disease monitoring. Some LAIPs are associated with underlying cytogenetic abnormalities and hence impact the management and prognosis.
白血病细胞表达一组特征性的“分化簇”（CD）标志物，这构成了当前世界卫生组织分类的基础。白血病相关异常免疫表型（LAIP）是指白血病细胞表达异常的CD标志物，这些标志物通常不由其相应谱系表达。LAIP的发生率差异很大，其临床意义、预后相关性以及对治疗的敏感性仍存在争议。本研究旨在确定我院新诊断白血病的免疫表型异常情况。
这是一项观察性研究，纳入了通过流式细胞术新诊断的白血病患者。一旦出现异常免疫表型表达，即进行记录，并与年龄、性别和白细胞总数（TLC）等预后因素相关联。
该研究在1.5年期间纳入了110例新诊断的白血病病例（85例急性白血病和25例慢性白血病）。40.4%的病例检测到免疫表型异常。异常发生率最高的是急性髓系白血病（60.7%）。在50%的T细胞急性淋巴细胞白血病和25%的B细胞急性淋巴细胞白血病（B-ALL）病例中检测到LAIP。B-ALL中异常的CD33和CD56表达分别与较高年龄和较高TLC等不良预后因素相关。28%的慢性淋巴细胞白血病病例存在免疫表型异常。
本研究结果产生了该地区LAIP发生率的宝贵基线数据。这些信息至关重要，因为在诊断时确定LAIP对于疾病监测至关重要。一些LAIP与潜在的细胞遗传学异常相关，因此会影响治疗和预后。
