Jie Xu, Do Hwan Kim, Wei Wang, Shaoying Li, Pei Lin, Guilin Tang, Sergej Konoplev, Lianqun Qiu, Hong Fang, Sofia Garces, Vasiliki Leventaki, Shuyu E, L Jeffrey Medeiros, Sa A Wang
{"title":"Flow cytometric immunophenotypic features of acute myeloid leukemia with mast cell differentiation.","authors":"Jie Xu, Do Hwan Kim, Wei Wang, Shaoying Li, Pei Lin, Guilin Tang, Sergej Konoplev, Lianqun Qiu, Hong Fang, Sofia Garces, Vasiliki Leventaki, Shuyu E, L Jeffrey Medeiros, Sa A Wang","doi":"10.1093/ajcp/aqae116","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Acute myeloid leukemia (AML) with mast cell (MC) differentiation was recently described as an aggressive subgroup of AML cases. The objectives of this study were to assess the flow cytometric immunophenotypic features of AML-MC cases.</p><p><strong>Methods: </strong>We characterized the immunophenotypic features of 21 AML-MC cases by flow cytometry and compared them to 20 reactive/regenerating bone marrow specimens.</p><p><strong>Results: </strong>The number of MCs detected by flow cytometry in AML-MC cases ranged from 0.4% to 21.1%, with a median of 3.5%, significantly higher than that of normal/reactive bone marrow (BM) (median, 0.01%; range, 0.000%-0.396%; P < .0001). Immunophenotypically, MCs in AML-MC cases demonstrated immaturity, differing from MCs in normal/reactive BMs, including dimmer CD45 (100% vs 0%), lower side scatter (100% vs 0%), more frequent CD34 (81% vs 20%), and CD123 (100% vs 10%) positivity, and more frequent uniform/increased CD38 expression (95% vs 20%) (all P ≤ .0001). CD2 (0/5) and CD25 (2/6, 1 uniform and 1 partial) were assessed in a subset of cases. The myeloblasts in AML-MC were typically CD34+CD117+HLA-DR+ with unusually frequent expression of CD56 (57%, all partial) and CD25 (63%, mostly partial), increased CD117 (62%), and decreased CD38 (86%). The MC percentage determined by flow cytometry correlated well with MCs detected by tryptase immunohistochemistry (r = 0.76, P < .001).</p><p><strong>Conclusions: </strong>The MCs in AML-MC cases are characterized by dim CD45, low side scatter, CD34 and CD123 positivity, and uniform and increased CD38 expression. Flow cytometry is an excellent tool for identifying AML-MC cases.</p>","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Bio Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ajcp/aqae116","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MATERIALS SCIENCE, BIOMATERIALS","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Acute myeloid leukemia (AML) with mast cell (MC) differentiation was recently described as an aggressive subgroup of AML cases. The objectives of this study were to assess the flow cytometric immunophenotypic features of AML-MC cases.
Methods: We characterized the immunophenotypic features of 21 AML-MC cases by flow cytometry and compared them to 20 reactive/regenerating bone marrow specimens.
Results: The number of MCs detected by flow cytometry in AML-MC cases ranged from 0.4% to 21.1%, with a median of 3.5%, significantly higher than that of normal/reactive bone marrow (BM) (median, 0.01%; range, 0.000%-0.396%; P < .0001). Immunophenotypically, MCs in AML-MC cases demonstrated immaturity, differing from MCs in normal/reactive BMs, including dimmer CD45 (100% vs 0%), lower side scatter (100% vs 0%), more frequent CD34 (81% vs 20%), and CD123 (100% vs 10%) positivity, and more frequent uniform/increased CD38 expression (95% vs 20%) (all P ≤ .0001). CD2 (0/5) and CD25 (2/6, 1 uniform and 1 partial) were assessed in a subset of cases. The myeloblasts in AML-MC were typically CD34+CD117+HLA-DR+ with unusually frequent expression of CD56 (57%, all partial) and CD25 (63%, mostly partial), increased CD117 (62%), and decreased CD38 (86%). The MC percentage determined by flow cytometry correlated well with MCs detected by tryptase immunohistochemistry (r = 0.76, P < .001).
Conclusions: The MCs in AML-MC cases are characterized by dim CD45, low side scatter, CD34 and CD123 positivity, and uniform and increased CD38 expression. Flow cytometry is an excellent tool for identifying AML-MC cases.
研究目的肥大细胞（MC）分化的急性髓性白血病（AML）最近被描述为AML病例的一个侵袭性亚组。本研究旨在评估AML-MC病例的流式细胞免疫表型特征：我们通过流式细胞术鉴定了21例AML-MC病例的免疫表型特征，并将其与20例反应性/再生性骨髓标本进行了比较：流式细胞术在AML-MC病例中检测到的MC数量从0.4%到21.1%不等，中位数为3.5%，明显高于正常/反应性骨髓（BM）（中位数，0.01%；范围，0.000%-0.396%；P < .0001）。从免疫表型上看，AML-MC病例中的MC与正常/反应性骨髓中的MC不同，显示出不成熟性，包括CD45（100% vs 0%）较暗，侧散射（100% vs 0%）较低，CD34（81% vs 20%）和CD123（100% vs 10%）阳性更频繁，CD38表达均匀/增加更频繁（95% vs 20%）（所有P均≤ .0001）。CD2（0/5）和CD25（2/6，1个均匀表达，1个部分表达）在部分病例中进行了评估。AML-MC中的骨髓母细胞通常为CD34+CD117+HLA-DR+，CD56（57%，全部为部分）和CD25（63%，大部分为部分）表达异常频繁，CD117增加（62%），CD38减少（86%）。流式细胞仪测定的MC百分比与胰蛋白酶免疫组化检测到的MC有很好的相关性（r = 0.76，P < .001）：结论：AML-MC病例中的MC具有CD45暗淡、侧散射低、CD34和CD123阳性、CD38表达均匀且增加等特点。流式细胞术是鉴别AML-MC病例的绝佳工具。
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