Research Information System
JOURNAL OF CONTEMPORARY MEDICINE, vol.13, pp.318-325, 2023 (Peer-Reviewed Journal)
Aim: The development of new therapeutic options to treat leukemia (therapies
targeting chimeric antigen receptor (CAR) T cells) down-regulates markers expressed
on the cell surface. Therefore, conventional immunophenotyping panels no longer
make these antigens unreliable for identifying a B cell immunophenotype. In our
study, we methodically compared multiparametric flow cytometry (FC) in bone
marrow aspiration and immunohistochemical (IHC) analysis in bone marrow biopsy
in childhood acute lymphoblastic leukemia (ALL). We sought to answer whether these
two methods could be alternatives to each other in the diagnosis of leukemia.
Material and Method: Twenty-eight patients diagnosed with ALL were included in
the study. A Kappa test was performed between the expression rates of the antibodies
studied in simultaneous FC and IHC studies in bone marrow aspiration and biopsy
samples performed at the initial diagnosis.
Results: Twenty-three of the patients were precursor B-ALL (BCP-ALL) and 5 were
T-ALL. In the immunophenotyping of patients with BCP-ALL using FC and IHC, MPO,
CD79A, CD14, CD3 expressions were the same, while CD19, CD7, CD117, CD33, CD
56, CD34 expressions were very good, good concordance for CD20 expressions and
moderate for CD10 expressions. In immunophenotyping of patients diagnosed with
T-ALL using FC and IHC, CD20, CD19, CD14, CD79a, MPO, CD22 expressions were the
same and excellent agreement was found in terms of CD2, CD10, CD34 expressions.
Conclusion: In cases where there are treatments that affect immunophenotyping,
costly methods such as FC are not available, or bone marrow aspiration cannot be
taken adequately, immunophenotyping with IHC can be safely performed in the
diagnosis of pediatric ALL in bone marrow biopsy.
Keywords: Acute Lymphoblastic leukemia, immunohistochemical, flow cytometry,
immunophenotyping