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Easy discrimination of hematogones from lymphoblasts in B‐cell progenitor acute lymphoblastic leukemia patients using CD 81/ CD 58 expression ratio
Author(s) -
Nagant Carole,
Casula Daniele,
Janssens Anne,
Nguyen Vo Thanh Phuong,
Cantinieaux Brigitte
Publication year - 2018
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/ijlh.12912
Subject(s) - lymphoblast , antigen , flow cytometry , myeloid , microbiology and biotechnology , myeloid leukemia , progenitor cell , leukemia , immunology , chemistry , medicine , biology , cell culture , stem cell , genetics
The discrimination of leukemia lymphoblasts ( LB ) in diagnosis and follow‐up of B‐cell progenitor acute lymphoblastic leukemia ( BCP ‐ ALL ) by multiparameter flow cytometry ( MFC ) may be difficult due to the presence of hematogones ( HG ). The aim of this study was to compare lymphoblasts of BCP ‐ ALL and HG for the expression of the most discriminating antigens. Methods A total of 82 bone marrow samples (39 BCP ‐ ALL and 43 patients with HG ) were analyzed using MFC . Mean fluorescence intensity ( MFI ) was measured for ten markers commonly used in hematology laboratories: CD 45, CD 19, CD 10, CD 34, CD 38, CD 20, CD 22, CD 58, CD 81, and CD 123. Statistical comparison of the MFI between LB and HG was performed. The presence on LB of aberrant expression of myeloid and/or T‐cell markers was also investigated. Results Qualitative pattern expression of antigens showed overexpression on LB of CD 58, CD 22, CD 34, CD 10 and underexpression of CD 81, CD 45, CD 38 when compared to HG . Expression of CD 123 was positive in 34% of BCP ‐ ALL LB and always absent on HG . Aberrant antigen expression (myeloid and/or T‐cell marker) including CD 123 was observed in 58% of BCP ‐ ALL patients. The use of a MFI antigen ratio of the most discriminating markers ( CD 81/ CD 58) (analysis of variance, P < 0.005) increased the distinction of LB versus HG with a high specificity and sensitivity as demonstrated by the use of ROC curve analysis ( AUC of CD 81/ CD 58: 0.995). Conclusion We demonstrate in this study that routine use of the MFI antigen ratio ( CD 81/ CD 58) in addition to the MFC evaluation using WHO classical criteria appears to be an efficient approach to discriminate LB from HG .