Saqlain Nazish, Hareem Sidra, Batool Fatima, Mahmood Khalid
Nazish Saqlain, FCPS (Hematology) Associate Professor of Pathology, Department of Hematology & Transfusion Medicine, UCHS, The Children's Hospital Lahore, Lahore - Pakistan.
Sidra Hareem, FCPS (Hematology) Assistant Professor of Hematology, Department of Hematology & Transfusion Medicine, UCHS, The Children's Hospital Lahore, Lahore - Pakistan.
Pak J Med Sci. 2025 Mar;41(3):816-820. doi: 10.12669/pjms.41.3.9717.
BACKGROUND & OBJECTIVE: Pediatric acute leukemias can present with aberrant immunophenotypes characterized by a different pattern of antigen expression on malignant cells, unlike the process of usual hematopoietic maturation. The objective of this study was to determine the aberrant immunophenotype expressions in newly diagnosed pediatric acute lymphoblastic and acute myeloid leukemias.
This cross-sectional study was carried out at University of Child Health Sciences, The Children's Hospital, Lahore, from October 2022 to December 2022 after IRB approval. After taking informed consent from parents/guardians, 290 children diagnosed with acute leukemia were included in the study. Peripheral blood or bone marrow samples in EDTA vial were used for flowcytometric analysis by using BD FACS Canto II flow-cytometer. The data was collected on a pre-designed proforma and analyzed by using IBM-SPSS V-23.
Among 290 cases, Acute Lymphoblastic Leukemia (ALL) constituted 221(76.2%) cases and 69(23.7%) were Acute Myeloid Leukemia (AML). Out of the total, the aberrant antigens were present in 32(11%) patients with 40 total events (18.1% immunophenotype aberrancy rate). The most common aberrant antigens were reported in B-ALL and the most common aberrant expression was of CD13 (62.5%). In AML, the most common aberrant antigen seen was CD19 (55.6%) and in T-ALL the most common were CD117 and HLA-DR (26.6%).
The most aberrant immunophenotypic markers were seen mostly in B-ALL pediatric cases followed by AML and T-ALL. Such abnormal expressions should be kept in mind while diagnosing the children with acute leukemia as they may affect the prognosis.
小儿急性白血病可呈现异常免疫表型,其特征为恶性细胞上抗原表达模式与正常造血成熟过程不同。本研究的目的是确定新诊断的小儿急性淋巴细胞白血病和急性髓细胞白血病中的异常免疫表型表达。
本横断面研究于2022年10月至2022年12月在拉合尔儿童医院儿童健康科学大学进行,经机构审查委员会批准。在获得家长/监护人的知情同意后,290名诊断为急性白血病的儿童被纳入研究。使用乙二胺四乙酸(EDTA)管采集的外周血或骨髓样本,通过BD FACS Canto II流式细胞仪进行流式细胞术分析。数据收集在预先设计的表格上,并使用IBM-SPSS V-23进行分析。
在290例病例中,急性淋巴细胞白血病(ALL)占221例(76.2%),急性髓细胞白血病(AML)占69例(23.7%)。在所有病例中,32例(11%)患者存在异常抗原,共40个事件(免疫表型异常率为18.1%)。B-ALL中报告的最常见异常抗原,最常见的异常表达是CD13(62.5%)。在AML中,最常见的异常抗原是CD19(55.6%),在T-ALL中最常见的是CD117和HLA-DR(26.6%)。
最异常的免疫表型标志物大多见于小儿B-ALL病例,其次是AML和T-ALL。在诊断小儿急性白血病时应牢记这种异常表达,因为它们可能影响预后。