Immunophenotyping of T-cell acute lymphoblastic leukaemia: Practical hurdles
Background: The 2016 WHO classification of T cell acute lymphoblastic leukemia suggest that cases of pre and pro T cell Acute Lymphoblastic Leukaemia (T-ALL) now fall under Early T-cell precursor ALL (ETP-ALL) or Near ETP ALL. Accurate subtyping is essential as the subsets are characterized by dist...
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| Format: | Article |
| Language: | English |
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Krishna Institute of Medical Sciences University
2023-10-01
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| Series: | Journal of Krishna Institute of Medical Sciences University |
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| Online Access: | https://jkimsu.com/jkimsu-vol12no4/JKIMSU,%20Vol.%2012,%20No.%204,%20October-December%202023%20Page%2081-91.pdf |
| _version_ | 1797248213936242688 |
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| author | Priya Pai Sushma Belurkar Sindhura Lakshmi K. L. |
| author_facet | Priya Pai Sushma Belurkar Sindhura Lakshmi K. L. |
| author_sort | Priya Pai |
| collection | DOAJ |
| description | Background: The 2016 WHO classification of T cell acute lymphoblastic leukemia suggest that cases of pre and pro T cell Acute Lymphoblastic Leukaemia (T-ALL) now fall under Early T-cell precursor ALL (ETP-ALL) or Near ETP ALL. Accurate subtyping is essential as the subsets are characterized by distinct molecular profiles and identifying molecular aberrations allow patients to receive novel treatment agents. Aim and Objectives: To study the immunophenotypic characteristics in T-ALL cases and assess the diagnostic difficulties encountered in its subtyping. Material and Methods: Thirty-seven cases of T-ALL were analysed on flow cytometry using a 6/8 colour panel of monoclonal antibodies, including B cell, T-cell, myeloid and stem cell markers. The cases were categorized as ETP-ALL, near ETP-ALL, cortical T-ALL and medullary T-ALL. Clinical details were retrieved from patient case files. Results: Patient age ranged from 1 to 64 years. Male to female ratio was 2.1: 1 and 35.1% cases were documented to have mediastinal mass. Mean haemoglobin level was 8.6 g/dl, and median total WBC count was 118.3 × 10 /µl. Blast percentage ranged from 39-98%, with mean of 84.8%. On flow cytometry analysis, all cases expressed CD7 and cytoplasmic CD3. CALLA+ (CD10+) were 32.4% cases. The aberrant expression of B-cell marker (CD79a) was observed in 5.4% cases. Majority of the cases were classified as medullary T-ALL, constituting 37.8% cases. ETP ALL were 21.6% cases, 13.5% cases were near ETP-ALL and 24.3% cases were cortical T-ALL. One case could not
be definitely assigned to a specific category. Conclusion: This study reflects the difficulties encountered in subtyping of T-ALL cases due to antigenic overlap and/or due to lack of an extended panel of secondary markers. |
| first_indexed | 2024-04-24T20:11:01Z |
| format | Article |
| id | doaj.art-7775f29e9cbd43e59786d26f359f0cc5 |
| institution | Directory Open Access Journal |
| issn | 2231-4261 |
| language | English |
| last_indexed | 2024-04-24T20:11:01Z |
| publishDate | 2023-10-01 |
| publisher | Krishna Institute of Medical Sciences University |
| record_format | Article |
| series | Journal of Krishna Institute of Medical Sciences University |
| spelling | doaj.art-7775f29e9cbd43e59786d26f359f0cc52024-03-23T10:37:47ZengKrishna Institute of Medical Sciences UniversityJournal of Krishna Institute of Medical Sciences University2231-42612023-10-011248191 Immunophenotyping of T-cell acute lymphoblastic leukaemia: Practical hurdles Priya Pai0Sushma Belurkar 1Sindhura Lakshmi K. L.2Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal-576104 (Karnataka) IndiaDepartment of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal-576104 (Karnataka) IndiaDepartment of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal-576104 (Karnataka) India Background: The 2016 WHO classification of T cell acute lymphoblastic leukemia suggest that cases of pre and pro T cell Acute Lymphoblastic Leukaemia (T-ALL) now fall under Early T-cell precursor ALL (ETP-ALL) or Near ETP ALL. Accurate subtyping is essential as the subsets are characterized by distinct molecular profiles and identifying molecular aberrations allow patients to receive novel treatment agents. Aim and Objectives: To study the immunophenotypic characteristics in T-ALL cases and assess the diagnostic difficulties encountered in its subtyping. Material and Methods: Thirty-seven cases of T-ALL were analysed on flow cytometry using a 6/8 colour panel of monoclonal antibodies, including B cell, T-cell, myeloid and stem cell markers. The cases were categorized as ETP-ALL, near ETP-ALL, cortical T-ALL and medullary T-ALL. Clinical details were retrieved from patient case files. Results: Patient age ranged from 1 to 64 years. Male to female ratio was 2.1: 1 and 35.1% cases were documented to have mediastinal mass. Mean haemoglobin level was 8.6 g/dl, and median total WBC count was 118.3 × 10 /µl. Blast percentage ranged from 39-98%, with mean of 84.8%. On flow cytometry analysis, all cases expressed CD7 and cytoplasmic CD3. CALLA+ (CD10+) were 32.4% cases. The aberrant expression of B-cell marker (CD79a) was observed in 5.4% cases. Majority of the cases were classified as medullary T-ALL, constituting 37.8% cases. ETP ALL were 21.6% cases, 13.5% cases were near ETP-ALL and 24.3% cases were cortical T-ALL. One case could not be definitely assigned to a specific category. Conclusion: This study reflects the difficulties encountered in subtyping of T-ALL cases due to antigenic overlap and/or due to lack of an extended panel of secondary markers. https://jkimsu.com/jkimsu-vol12no4/JKIMSU,%20Vol.%2012,%20No.%204,%20October-December%202023%20Page%2081-91.pdfimmunophenotypeacute lymphoblastic leukaemiaflow cytometryblasts |
| spellingShingle | Priya Pai Sushma Belurkar Sindhura Lakshmi K. L. Immunophenotyping of T-cell acute lymphoblastic leukaemia: Practical hurdles Journal of Krishna Institute of Medical Sciences University immunophenotype acute lymphoblastic leukaemia flow cytometry blasts |
| title | Immunophenotyping of T-cell acute lymphoblastic leukaemia: Practical hurdles |
| title_full | Immunophenotyping of T-cell acute lymphoblastic leukaemia: Practical hurdles |
| title_fullStr | Immunophenotyping of T-cell acute lymphoblastic leukaemia: Practical hurdles |
| title_full_unstemmed | Immunophenotyping of T-cell acute lymphoblastic leukaemia: Practical hurdles |
| title_short | Immunophenotyping of T-cell acute lymphoblastic leukaemia: Practical hurdles |
| title_sort | immunophenotyping of t cell acute lymphoblastic leukaemia practical hurdles |
| topic | immunophenotype acute lymphoblastic leukaemia flow cytometry blasts |
| url | https://jkimsu.com/jkimsu-vol12no4/JKIMSU,%20Vol.%2012,%20No.%204,%20October-December%202023%20Page%2081-91.pdf |
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