Pattern of Immunophenotypic Aberrant Expression in De-Novo Acute Leukaemia

K. Islam, I. Jahan, Md. Adnan Hasan Masud, M. Hossain, Nishat Mahzabin, Md. Arif-Ur- Rahman, M. Ahmed, Mujahida Rahman, Md Salahuddin Shah, Md. Abdul Aziz, M. Begum, A. Yunus
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Abstract

Background: Aberrant expression (AE) of Acute Leukaemia (AL) is essential to confirm the diagnosis of AL patients whether it is biphenotypic/mix phenotypic AL or it is AL with AE. Objectives:  This study is conducted to observe the diversity of aberrant immunophenotypic expressions among the patients of acute leukaemia with varying frequencies, to find out the correlation between aberrantly expressed immunophenotypic markers with different variety of French American British (FAB) sub classification of acute leukaemia and any correlation of clinical presentation of AL patients with aberrantly expressed immunophenotypic markers. Methodology: This cross-sectional observational study was carried out in the department of Haematology, BSMMU, Bangladesh on 50 patients from 14 to 65 years of age of both sex of newly diagnosed de- novo untreated AL patients from January 2017 to June 2018. Informed written consent & clinical history is taken and physical examinations were done in a predesigned data collection sheet. Then Bone marrow (BM) with peripheral blood sample for morphology and immunophenotyping were done in the laboratory of the Haematology department of BSMMU. After collection of data, these data were analysed for the final result. Result: In this study, 24 (48%) patients of de-novo Acute Leukaemia have Immunophenotypic aberrant expressions. Among them 12 (24%) patients were AML with AE, 9 (18%) patients were B ALL with AE, 3 (6%) patients were T ALL with AE and 2 (4%) patients were MPAL. In case of AML the most frequent Lymphoid aberrant marker is CD7 (12%), In B ALL the most frequent aberrant marker is CD5 (10%) and in T ALL the most frequent aberrant marker is CD10 (4%). Conclusion: In de-novo acute leukaemia, there is significant number of patients have aberrant expression which should be differentiated from biphenotypic/mix phenotypic AL for therapeutic and prognostic implications.
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新生急性白血病免疫表型异常表达模式
背景:急性白血病(AL)的异常表达(AE)对于确认AL患者的诊断至关重要,无论是双表型/混合表型AL还是AL合并AE。目的:观察不同频率急性白血病患者中异常免疫表型表达的多样性,探讨不同种类法、美、英(FAB)急性白血病亚分类中异常免疫表型标志物的表达与AL患者临床表现与异常免疫表型标志物的相关性。方法:这项横断面观察性研究于2017年1月至2018年6月在孟加拉国BSMMU血液科对50名14至65岁的新诊断的未经治疗的AL患者进行了研究。收集知情书面同意书和临床病史,并在预先设计的数据收集表中进行体格检查。骨髓与外周血标本在北京医科大学血液科实验室进行形态学和免疫表型分析。收集数据后,对这些数据进行分析,得出最终结果。结果:在本研究中,24例(48%)新生急性白血病患者存在免疫表型异常表达。其中AML合并AE 12例(24%),B型ALL合并AE 9例(18%),T型ALL合并AE 3例(6%),MPAL 2例(4%)。在AML中,最常见的淋巴异常标记是CD7(12%),在B ALL中最常见的异常标记是CD5(10%),在T ALL中最常见的异常标记是CD10(4%)。结论:在新生急性白血病中,有相当数量的患者存在异常表达,应与双表型/混合表型AL区分,以获得治疗和预后意义。
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