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CA Hanson, KJ Gajl-Peczalska, JL Parkin and RD Brunning
The leukemic cells from 41 cases of acute myeloid leukemia (AML) and 17
cases of acute lymphocytic leukemia (ALL) were immunophenotyped by the
alkaline phosphatase-antialkaline phosphatase (APAAP) immunocytochemical
technique utilizing eight monoclonal antibodies (MoAb) reactive with cells
of myeloid origin and seven MoAb reactive with lymphoid antigens. Ninety
percent of the cases of AML reacted with one or more of the pan-myeloid
MoAb, My7, My9, or 20.3. Reactivity of the myeloid panel of MoAb showed
some correlation with the French- American-British (FAB) classification of
AML. Five of six cases of acute promyelocytic leukemia (APL) were HLA-DR
negative; the one HLA-DR- positive APL had a minor population of
HLA-DR-negative promyelocytes. OKM5 and/or My4 reacted with 16 of 16
monocytic leukemias. No specific marker of early erythroid development was
identified. AP3, a MoAb reactive with platelet glycoprotein (GPIIIa), was
specific for acute megakaryoblastic leukemia. Immunocytochemistry was also
helpful in classifying seven cases of AML with equivocal or negative
routine cytochemistry. Two cases of AML had minor populations of blasts
detected by the APAAP technique that were immunologically distinct from the
major blast population; these minor populations emerged as the predominant
cell type at relapse. Two cases of ALL expressed multiple myeloid and
lymphoid antigens. Two other cases that morphologically were ALL reacted
with only myeloid MoAb; one consisted entirely of immature basophils on
ultrastructural examination. Immunophenotyping results using the APAAP
technique were comparable with those obtained with flow cytometry. The
APAAP technique is a reliable method for immunophenotyping leukemia that
complements other methods of immunologic evaluation. The primary advantages
of this method include its use with routinely prepared blood and bone
marrow smears and the ability to correlate immunocytochemical reactions
with morphology.
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| Copyright © 1987 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||