Comment on: Value of flow cytometric analysis of peripheral blood samples in children diagnosed with acute lymphoblastic leukemia

To determine the cellular basis for the excellent clinical outcome of hyperdiploid acute lymphoblastic leukemia (ALL), defined by a modal chromosome number of 51 to 65, we assessed the growth potential of leukemic cells from 129 children with newly diagnosed ALL. Flow cytometric analysis was used to compare leukemic cell recoveries at the beginning and at the end of 7-day cultures on allogeneic bone marrow–derived stromal layers. The median percentage of cell recovery after culture was 91% (range, <1% to 550%). Among the 25 hyperdiploid cases, only two had cell recoveries above the median value, compared with 63 of 104 cases with different ploidies (P< .001); 21 had recoveries within the first quartile, in contrast to only 12 of the 104 other cases. Cell recoveries in the 16 cases with duplications of chromosomes 4 and 10, a feature previously associated with a superior outcome, were all within the first quartile. Flow cytometric studies indicated that rapid induction of apoptosis was the underlying cause of low cell recoveries in cases with hyperdiploidy. The demise of hyperdiploid cells on stroma was not due to failure to adhere with stromal elements (as shown by electron microscopy) or to deficiencies of interleukin-1 (IL-1), IL-2, IL-3, IL-4, IL-6, IL-7, IL-11, stem-cell factor, interferon- (IFN-), tumor necrosis factor- (TNF-), or to combinations of these cytokines. Inactivation of IL-4, IFN- and TNF-, which if secreted by stromal layers could be toxic to ALL cells, failed to improve the survival of hyperdiploid blasts. We conclude that leukemic cells bearing 51 to 65 chromosomes have a marked propensity to undergo apoptosis. The stringent survival requirements of these cells, together with their potentially higher sensitivity to antileukemic drugs, may well account for the high cure rates achieved in patients with this form of ALL.

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Near-haploid acute lymphoblastic leukemia: a unique subgroup with a poor prognosis?

Blood ◽

10.1182/blood.v58.1.14.bloodjournal58114 ◽

1981 ◽

Vol 58 (1) ◽

pp. 14-19 ◽

Cited By ~ 1

Author(s):

GM Brodeur ◽

DL Williams ◽

AT Look ◽

WP Bowman ◽

DK Kalwinsky

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Dna Content ◽

Poor Prognosis ◽

Lymphoblastic Leukemia ◽

Periodic Acid ◽

Flow Cytometric Analysis ◽

Chromosome 21 ◽

Periodic Acid Schiff ◽

Flow Cytometric ◽

Block Pattern

We describe two adolescent girls with acute lymphoblastic leukemia (ALL) whose leukemia cells were near-haploid. Their lymphoblasts stained in a block pattern with periodic acid Schiff and had “common ALL” surface markers confirmed by indirect immunofluorescence. Each patient had two populations of blasts, one near-haploid and one hyperdiploid, which was an exact doubling of the near-haploid karyotype. The first patient had a predominant population of cells with 26 chromosomes and a few with 52, while the second had a predominance of cells with 56 and a minority with 28. Flow cytometric analysis of DNA content initially detected the minor near-haploid population in the second patient, which was confirmed later by cytogenetic review of the marrow sample. In addition to our two patients, only four patients have been reported with near-haploid ALL. Of these six, five were girls, five were adolescents, and five had short survivals (median, 10 mo). All six had disomy of chromosome 21 with or without disomy for chromosomes 10, 14, 18, or X (four patients each). Thus, near-haploid ALL may represent a unique subgroup of ALL with a poor prognosis. To detect these and other possible subgroups, we have included cytogenetic analysis and flow cytometric analysis of DNA content in our initial evaluation of patients with ALL.

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Flow cytometric analysis of cytokinetics of L3-acute lymphoblastic leukemia/lymphoma

Leukemia Research ◽

10.1016/0145-2126(92)90031-2 ◽

1992 ◽

Vol 16 (9) ◽

pp. 853-859 ◽

Cited By ~ 3

Author(s):

Stuart M. Lichtman ◽

Michael Andreeff

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Lymphoblastic Leukemia ◽

Flow Cytometric Analysis ◽

Flow Cytometric

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Use of Four-Color Flow Cytometric Assay for Discrimination of Hematogone from Lymphoblast: Critical Issue for MRD Assessment in B-ALL Patients

Iranian Journal of Pediatric Hematology & Oncology ◽

10.18502/ijpho.v10i1.2166 ◽

2020 ◽

Author(s):

Mehdi Allahbakhshian Farsani ◽

Esmaeil Shahabi Satlsar ◽

Alireza Mohseni ◽

Mohammad Mosleh ◽

Mahdieh Mehrpouri ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

B Cell ◽

Residual Disease ◽

Lymphoblastic Leukemia ◽

Flow Cytometric Analysis ◽

Critical Issue ◽

Color Flow ◽

Flow Cytometric ◽

Cell Acute Lymphoblastic Leukemia ◽

Lymphoblastic Cells

Background: Hematogones are normal B-cell precursor which can be seen in different physiological and pathological conditions. Due to variation in B-cell acute lymphoblastic leukemia (B-ALL) blasts immunophenotyping and interference of hematogones in minimal residual disease (MRD) assessment, precise discrimination of hematogones is very crucial. The purpose of this study was to evaluate the expression pattern of surface markers in hematogones and compare them with lymphoblasts. Material and Methods: In this applied study, flow cytometric analysis was performed using Coulter FC-500 and MXP software in 4-color combination and 6 different tubes. In this study, 85 patients diagnosed with acute lymphoblastic leukemia were evaluated. Out of these patients, 45 were boys and 40 were girls. Patients aged from 1 to 15 years old. In addition, 27 bone marrow samples from other patients aged 4 to 18 years were included in this investigation. These samples had been obtained for other diagnostic purposes, such as immune thrombocytopenic purpura and juvenile idiopathic arthritis. Results: During flow cytometric analysis, hematogones showed expressions of CD19, CD20, CD22, CD10, CD45, CD81, CD123, CD9, CD34 (partial expression), and tdt (partial expression). In these patients, hematgones were negative for CD66c expression. Lymphoblastic cells were positive for CD19, CD20 (in some cases), CD22, CD10, CD45, CD81, CD123, CD58, CD9, CD66c, CD34 (in most cases), and TDT. CD81 mean fluorescence intensity (MFI) in hematogones was higher than that in lymphoblasts. (112.5 (30-251) vs. 17.5 (5-30); P<0.0001) Conclusion: According to findings of this study, it seems that the use of CD81, CD58, CD123, CD66c, CD9, and CD81 MFI in combination with B-Cells associated markers can be very effective in differentiating hematogone from lymphoblast.

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Near-haploid acute lymphoblastic leukemia: a unique subgroup with a poor prognosis?

Blood ◽

10.1182/blood.v58.1.14.14 ◽

1981 ◽

Vol 58 (1) ◽

pp. 14-19 ◽

Cited By ~ 61

Author(s):

GM Brodeur ◽

DL Williams ◽

AT Look ◽

WP Bowman ◽

DK Kalwinsky

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Dna Content ◽

Poor Prognosis ◽

Lymphoblastic Leukemia ◽

Periodic Acid ◽

Flow Cytometric Analysis ◽

Chromosome 21 ◽

Periodic Acid Schiff ◽

Flow Cytometric ◽

Block Pattern

Abstract We describe two adolescent girls with acute lymphoblastic leukemia (ALL) whose leukemia cells were near-haploid. Their lymphoblasts stained in a block pattern with periodic acid Schiff and had “common ALL” surface markers confirmed by indirect immunofluorescence. Each patient had two populations of blasts, one near-haploid and one hyperdiploid, which was an exact doubling of the near-haploid karyotype. The first patient had a predominant population of cells with 26 chromosomes and a few with 52, while the second had a predominance of cells with 56 and a minority with 28. Flow cytometric analysis of DNA content initially detected the minor near-haploid population in the second patient, which was confirmed later by cytogenetic review of the marrow sample. In addition to our two patients, only four patients have been reported with near-haploid ALL. Of these six, five were girls, five were adolescents, and five had short survivals (median, 10 mo). All six had disomy of chromosome 21 with or without disomy for chromosomes 10, 14, 18, or X (four patients each). Thus, near-haploid ALL may represent a unique subgroup of ALL with a poor prognosis. To detect these and other possible subgroups, we have included cytogenetic analysis and flow cytometric analysis of DNA content in our initial evaluation of patients with ALL.

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Combined metaphase, interphase cytogenetic, and flow cytometric analysis of DNA content of pediatric acute lymphoblastic leukemia

Cytometry ◽

10.1002/(sici)1097-0320(19980415)34:2<87::aid-cyto5>3.0.co;2-9 ◽

1998 ◽

Vol 34 (2) ◽

pp. 87-94 ◽

Cited By ~ 16

Author(s):

L. Pajor ◽

K. Szuhai ◽

G. Mehes ◽

G. Kosztol�nyi ◽

P. J�ks� ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Dna Content ◽

Lymphoblastic Leukemia ◽

Flow Cytometric Analysis ◽

Pediatric Acute Lymphoblastic Leukemia ◽

Flow Cytometric

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Hematogones as an Internal Control in Flow Cytometric Analysis of Suspected Acute Lymphoblastic Leukemia

Pediatric and Developmental Pathology ◽

10.1007/s100249900137 ◽

1999 ◽

Vol 2 (4) ◽

pp. 371-376 ◽

Cited By ~ 3

Author(s):

Sara O. Vargas ◽

Susan L. Hasegawa ◽

David M. Dorfman

Keyword(s):

Acute Lymphoblastic Leukemia ◽

B Cell ◽

Internal Control ◽

Lymphoblastic Leukemia ◽

Flow Cytometric Analysis ◽

Terminal Deoxynucleotidyl Transferase ◽

Flow Cytometric ◽

Immature B Cells ◽

Discrete Population ◽

Cell Surface Staining

Hematogones are benign immature B cells that commonly populate the bone marrow of children. Their presence has been noted to interfere with the flowcytometric analysis of cases of suspected acute lymphoblastic leukemia (ALL) because their immunophenotype (positive for CD19, CD10, CD34, and terminal deoxynucleotidyl transferase) is similar to that of pre–B cell lymphoblasts. Here we report a case in which the presence of a discrete population of hematogones, characterized by low-intensity CD10 cell-surface staining compared with pre–B cell lymphoblasts, actually aided in the recognition of early relapsed ALL and disease progression over a 4-day period. We also review our experience with flow-cytometric immunophenotyping in pediatric cases of suspected leukemia to evaluate the frequency of this occurrence.

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