FLOW CYTOMETRY IMMUNOPHEMOTYPING EVALUATION IN ACUTE LYMPHOBLASTIC LEUKEMIA
Acute lymphoid leukemia. Immunophenotyping. Flow citometry.
Introduction: Acute Lymphoblastic Leukemia (ALL) is a malignant disease of the lympho-hematopoietic system characterized by the accumulation of neoplastic lymphoid precursors (lymphoblasts) of origin B or T in the bone marrow (BM) and/or peripheral blood (PB). The diagnosis and classification of these leukemias occurs by the French-American-British morphological classification (L1, L2 or L3) associated with characteristics of the immune profile of T or B cell malignancy, based on the expression profile of monoclonal antibodies (MoAb) directed against cell differentiation antigens by flow cytometry (FC). Several studies have found that blast cell immunophenotypes do not always have the characteristics of normal lymphoid differentiation, but exhibit aberrant immunophenotypes. Thus, the blasts of some cases of ALLB may have T or myeloid antigens, as well as T cells of ALL may have B or myeloid antigens. Objectives: To determine the immunophenotypic profile by FC in 88 patients with ALL (lineage B or T) diagnosed at the Flow Cytometry Laboratory of the Hemocentro Dalton Cunha - HEMONORTE, in the state of Rio Grande do Norte, Brasil. Methodology: The samples, such as PB and/or BM, were subjected to FC immunophenotyping using a specific MoAb panel for the diagnosis of acute leukemia (AL) directly conjugated to fluorochromes. Results: The age of patients ranged from 1 month to 84 years, with amedian of 13 years, with 62.5% being male. The most frequent strain observed was B and the most evident subtype was the Common Pre-B ALL. Among the cell markers emitted, the most expressed in lineage B were CD19, CD10, HLADR and cCD79a and the most expressed antigens in lineage T were CD3, CD7, CD5 and CD2. A small percentage (6.8%) was doubly positive T cells. Conclusion: It is concluded that theindividuals with ALL in this study have demographic, clinical and immunophenotypic characteristics similar to those observed in other studies, demonstrating that FC is an essential methodology in the diagnosis and follow-up of these leukemias.