Buradasınız

Acute lymphoblastic leukemia in northern India

Journal Name:

Publication Year:

Abstract (2. Language): 
Objective: To study the morphology, analyse the immunophenotype of acute lymphoblastic leukemias by flowcytometry and compare the morphology with immunophenotypic profile. Materials and methods: The present study was conducted in the Department of Pathology at Rajiv Gandhi Cancer Institute to evaluate and analyze morphology and immunophenotype of acute lymphoblastic leukemias. A total of 75 cases that presented to the Hemato-Oncology OPD, and were diagnosed and documented as Acute Leukemias, prospectively during the period January 2009 to December 2011, were included in the present study. Only newly diagnosed untreated acute leukemia patients of all age groups and both sexes were included in the study. A written consent was taken from patients or parents as appropriate. The diagnosis of acute leukemia was established based on peripheral blood and bone marrow morphology and cytochemistry. Immunophenotyping was done in all cases. Results: Out of the 75 cases included in the study period, Acute myeloid leukemia comprised 31 of 75 cases (41.3%), acute lymphoblastic leukemia comprised of 40 of 75 cases (53.3%) and biphenotypic leukemias comprised the rest of 4 cases (5.3%). Out of total 40 cases of acute lymphoblastic leukemais,72%(29) cases had B cell phenotype while 28% (11) cases had T cell phenotype. B cell ALL was predominantly seen in children constituting 75.8 % while T cell ALL was predominantly seen in adults (72.7 %). Immunophenotypic analysis showed that the pro B-cell phenotype was encountered in 22 (53.6 %), mature B-cell in 7 (1.7%) and T-cell in 11 (26.8 %) cases. CD10 positivity was found in 27 cases of B cell ALL (93.1%) and 5 cases of the T-ALL (45.4%). Conclusion: The diagnostic accuracy and reproducibility of morphological diagnosis and cytochemistry varies between 70- 90% and this is further increased to greater than 95% by the incorporation of the flowcytometry in a resource poor country like ours where molecular and cytogenetic studies are available in limited centres.
372
381

REFERENCES

References: 

1. Jaffe ES, Harris NL, Stein H, Vardiman JW, eds. World Health Organization Classification of Tumours:
Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC Press;
2008.
2. Raina V, El-Habbash KI, Tenkovsky. Acute nonlymphoblastic leukemia in adults: experience in Tripoli
Libya. Ann Saudi Med 1990;10:299-302.
3. Velpeau A. Sur la resorptiendu pus et sur l'alteration du sang dans les malades. Revue Medicine.1827;2:216-
218.
4. Virchow R. Weisses Blut. Froriep's Notizen.1845;36:151-156.
5. SEER 17 registries for 2000-2003: age- specific SEER incidence rates by sex for acute leukemia: U.S.
Government, 2003.
6. Ries LAG, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, Clegg L, Horner MJ, Howlader N,
Eisner MP, Reichman M, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2004, National Cancer
Institute. Bethesda, MD.
7. Sandler DP, Collman GW. Cytogenetic and environmental factors in the etiology of the acute leukemias in
adults. Am J Epidemiol 1987; 126:1017–1032.
8. Bennett JM, Catovsky D, Daniel MT. Proposals for the classification of the acute leukaemias. Br J Haematol
1976; 33: 169- 170.
9. Bowman GP, Neame PB, Soamboonsrup P. The contribution of cytochemistry and immunophenotyping to
the reproducibility of the FAB classification in acute leukemia. Blood 1986; 68:900–905.
10. First MIC Cooperative Study Group. Morphologic, immunologic, and cytogenetic (MIC) working
classification of acute lymphoblastic leukaemias. Cancer Genet Cytogenet 1986; 23:189-97.
11. Second MIC Cooperative Study Group. Morphologic, immunologic and cytogenetic (MIC) working
classification of the acute myeloid leukaemias. Br 7 Haematol 1988; 68: 487-94.
12. Chaudhry MT, Tayyab M, Faooqi IA.Acute nonlymphoblastic leukemia in adults. J Pak Med Assoc 1993;
43:259-61.
17% 55%
28%
Percentage of
different …
pro B- cell
ALL
Mature Bcell
ALL
T-cell ALL
0
1
2
3
4
5
Series1
380
Indian Journal of Basic and Applied Medical Research; March 2015: Vol.-4, Issue- 2, P. 372-381
373
www.ijbamr.com P ISSN: 2250-284X , E ISSN : 2250-2858
13. Bennet JM, Catovsky D, Daniel MT, Flandrin G, Galton AG, Gralnick HR. The morphologic classification
of acute lymphoblastic leukaemia: concordance among observers and clinical correlations. Br J Haematol 1981;
47:553-561.
14. Davey FR, Castella A, Lauenstein K, Charlene Hubbell MT, Oates RP. Prognostic significance of the
revised French- American-British classification for acute lymphocytic leukaemia. Clin Lab Haemat 1983;
5:343-351.
15. Bennett JM. The classification of the acute leukemias: cytochemical and morphologic considerations. In:
Wiernik PH, Canellos GP, Kyle RA, Schiffer CA, eds. Neoplastic diseases of the blood. New York: Churchill
Livingstone, 1991:169–181.
16. Borowitz MJ, Guenther KL, Shults KE, Stelzer GT.Immunophenotyping of acute leukemia by flow
cytometric analysis: use of CD45 and right-angle light scatter to gate on leukemic blasts in three-color analysis.
American Journal of Clinical Pathology.1993;5:534–40.
17. Harrington AM, Olteanu H, Kroft SH. A dissection of the CD45/side scatter "blast gate". Am J Clin
Pathol. 2012;137:800-4.
18. Advani S, Pai S, Venzon D, Adde M, Kurkure PK, Nair CN, Sirohi B et al. Acute lymphoblastic leukemia in
India: An analysis of prognostic factors using a singletreatment regimen. Ann Oncol 1999; 10:176-176.
19. Magrath I, Shanta V, Advani S, Adde M, Arya LS, Banavali S et al. Treatment of acute lymphoblastic
leukemias in countries with limited resources; lessons from use of a single protocol in India over a twenty year
period. Eur J Cancer 2005; 41:1570-1583.
20. Sandler DP, Ross JA. Epidemiology of acute leukemia in children and adults. Semin Oncol 1997; 24:3-16.
21. C.-H. Pui, F. G. Behm, and W. M. Crist. Clinical and biologic relevance of immunologic marker studies in
childhood acute lymphoblastic leukemia.Blood.1993;82:343–62.
22. Consolini R, Legitimo A, Rondelli R, Guguelmi C, Barisone E, Lippi A, Cantu-Rajnoldi A, Arico M, Conter
V, Cocito MG, Putti MC, et al. Clinical relevance of CD10 expression in childhood ALL. The Italian
Association for Pediatric Hematology and Oncology (AIEOP).Haematologica.1998;83:967-73.
23. Braylan RC, Orfao A, Borowitz MJ, Davis BH. Optimal number of reagents required to evaluate
hematolymphoid neoplasis: Results on an international consensus meeting. Cytometry. 2001;46:23-7.
381

Thank you for copying data from http://www.arastirmax.com