Piedras J, López-Karpovitch X, Cárdenas M R
Departamento de Hematología-Oncología, Laboratorio de Biología Celular, Instituto Nacional de la Nutrición Salvador Zubirán, Vasco de Quiroga, México, D.F.
Rev Invest Clin. 1997 Nov-Dec;49(6):457-64.
To analyze hematopoietic cell surface antigen reactivity in acute leukemia (AL) by flow cytometry and identify acute mixed-lineage leukemias (AMLL) employing the most widely accepted criteria.
Ninety seven patients with de novo AL were studied. Cell surface antigens were investigated with monoclonal antibodies directed to: B lymphoid (CD10, CD19, CD20, CD21, CD22); T lymphoid (CD2, CD3, CD5, CD7); and myeloid (CD13, CD14, CD15, CD33, CD41) cell lineages. Maturation cell-associated antigens (CD34, HLA-DR and TdT) were also studied.
Twelve patients unclassified by cytomorphology could be classified by immunophenotype. Using cytomorphologic, cytochemical and immunophenotypic data, 54 cases corresponded to acute lymphoblastic leukemia (ALL) and 43 were acute myeloblastic leukemia (AML). In All there were 63% B lineage, 15% T, 7% T/B, 6% undifferentiated and 9% mixed-lineage (coexpression of two or more myeloid-associated antigens). In AML, myeloid immunophenotype was observed in 86% undifferentiated in 2%, and mixed-lineage in 12% (coexpression of two or more lymphoid-associated antigens). In addition, 26% of ALL cases and 12% of AML cases expressed a single myeloid and lymphoid antigen respectively. The most common aberrant antigens in ALL and AML were CD13 and CD7 respectively. The highest frequency of CD34 antigen expression (90%) was detected in patients with AMLL.
Flow cytometric immunophenotypic analysis allowed to: a) establish diagnosis in cytomorphologically unclassified cases; b) identify AMLL with a frequency similar to that reported in other series; and c) confirm the heterogeneity of AL.
通过流式细胞术分析急性白血病（AL）中造血细胞表面抗原反应性，并采用最广泛认可的标准识别急性混合谱系白血病（AMLL）。
对97例初发AL患者进行研究。用针对B淋巴系（CD10、CD19、CD20、CD21、CD22）、T淋巴系（CD2、CD3、CD5、CD7）和髓系（CD13、CD14、CD15、CD33、CD41）细胞谱系的单克隆抗体研究细胞表面抗原。还研究了成熟细胞相关抗原（CD34、HLA-DR和TdT）。
12例细胞形态学未分类的患者可通过免疫表型分类。根据细胞形态学、细胞化学和免疫表型数据，54例为急性淋巴细胞白血病（ALL），43例为急性髓细胞白血病（AML）。在ALL中，63%为B谱系，15%为T谱系，7%为T/B谱系，6%为未分化型，9%为混合谱系（两种或更多种髓系相关抗原共表达）。在AML中，86%观察到髓系免疫表型，2%为未分化型，12%为混合谱系（两种或更多种淋巴系相关抗原共表达）。此外，ALL病例的26%和AML病例的12%分别表达单一髓系和淋巴系抗原。ALL和AML中最常见的异常抗原分别为CD13和CD7。在AMLL患者中检测到CD34抗原表达的最高频率（90%）。
流式细胞术免疫表型分析能够：a）在细胞形态学未分类的病例中确立诊断；b）以与其他系列报道相似的频率识别AMLL；c）证实AL的异质性。
