Diagnostic Utility of Immunophenotyping by Flow Cytometry for Diagnosis and Classification of Acute Leukemias in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

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Addis Ababa University


Background: Immunophenotypic characterization of acute leukemia is an important clinical application of flow cytometery and has become a powerful tool contributing to proper diagnosis and classification. Objective: To phenotype and classify acute leukemias by flow cytometry using commonly used markers for leukemia diagnosis. Method: A total of 40 pediatric and adult patients diagnosed with acute leukemia were evaluated by flow cytometry with 17 surface and cytoplasmic markers known to be useful in discriminating different types of acute leukemia. Results: 21 of 40 patients (52.5%) were classified as Acute Myeloblastic leukemia (AML) while 19 (47.5%) were identified as Acute lymphoblastic leukemia (ALL). Of all the ALL cases, 10 of the 19 (52.6%) were B-ALL and 47.4% (9/19) were T-ALL. Markers of immaturity HLA-DR and CD34 antigens were co expressed in 61% of AML cases, and 33% of T-ALL cases, whereas CD34 was expressed in 50% of the B-ALL cases. MPO and CD13 were the most commonly expressed markers of AML, whereas CD19 and cCD79a were present in all cases of B-ALL. Cytoplasmic CD3 and CD7 were the most sensitive markers for T-ALL. Discrimination of AML from ALL patients by flow cytometry was 80% concordant with traditional morphology. Notable discrepancies occurred in cases where leukemia cells expressed markers for more than one lineage. Conclusion: Immunophenotyping by flow cytometry provides useful information to confirm diagnoses of standard morphology methodology, to provide classifications where morphology is indeterminate, and to provide further lineage and maturation information for ALL not obtainable by morphology is needed for ALL cases. It thus represents an important tool among many in leukemia classification and is realistic in the resource limited settings. Key words: Leukemia, ALL, AML, Flow cytometry, Immunophenotyping



Leukemia, ALL, AML, Flow cytometry