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Lineage identification of acute leukemias: relevance of immunologic and ultrastructural techniques.
Hematol Pathol. 1995; 9(2):79-94.HP

Abstract

This study assesses the value of immunologic and ultrastructural methods in disclosing the lineage commitment of cells from acute leukemias (ALs). Two hundred and fifty-one ALs were characterized morphologically, cytochemically, and immunologically. Myeloperoxidase (MPO) positivity in > 3% of blasts was regarded as evidence of the myeloid origin of leukemic cells, cytoplasmic CD22 (cCD22) expression was taken as an indication for B-lineage acute lymphoblastic leukemia (ALL), and CD3+ (membrane or cytoplasmic) cases were classified as T-ALL. Diagnosis of minimally differentiated acute myeloid leukemia (AML-M0) was made when blast cells had undifferentiated features by light microscopy, reacted with at least one of the antibodies to myeloid-specific antigens (CD13, CD33, MPO), and lacked CD19, cCD22, and c/mCD3. Megakaryoblastic differentiation was demonstrated by the expression of CD41 and/or CD61. Following these criteria, 209 cases were classified as acute myeloid leukemia (AML) and 39 as ALL. Expression of lymphoid antigens was detected in 45% of AML cases and 30% of ALLs showed myeloid antigens. One case was regarded as a true biphenotypic leukemia because of the combined expression of MPO and CD33 for the myeloid lineage, and cCD3, CD2, and CD5 for the T-cell lineage. Two cases lacked signs of myeloid or lymphoid differentiation and were studied by electron microscopy methods. One displayed platelet peroxidase (PPO) activity and was classified as a megakaryoblastic variant, one other reacted with anti-CD33 and was considered AML-M0. We conclude that light microscopy and standard immunologic methods can accurately demonstrate the lineage orientation in greater than 99% of ALs. Integration with ultrastructural analysis can define the cell nature of virtually all cases of AL.

Authors+Show Affiliations

Department of Hematology, University of Rome Tor Vergata, S. Eugenio Hospital, Rome, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7559258

Citation

Stasi, R, et al. "Lineage Identification of Acute Leukemias: Relevance of Immunologic and Ultrastructural Techniques." Hematologic Pathology, vol. 9, no. 2, 1995, pp. 79-94.
Stasi R, Del Poeta G, Venditti A, et al. Lineage identification of acute leukemias: relevance of immunologic and ultrastructural techniques. Hematol Pathol. 1995;9(2):79-94.
Stasi, R., Del Poeta, G., Venditti, A., Bruno, A., Suppo, G., Aronica, G., Di Carlo, G., & Papa, G. (1995). Lineage identification of acute leukemias: relevance of immunologic and ultrastructural techniques. Hematologic Pathology, 9(2), 79-94.
Stasi R, et al. Lineage Identification of Acute Leukemias: Relevance of Immunologic and Ultrastructural Techniques. Hematol Pathol. 1995;9(2):79-94. PubMed PMID: 7559258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lineage identification of acute leukemias: relevance of immunologic and ultrastructural techniques. AU - Stasi,R, AU - Del Poeta,G, AU - Venditti,A, AU - Bruno,A, AU - Suppo,G, AU - Aronica,G, AU - Di Carlo,G, AU - Papa,G, PY - 1995/1/1/pubmed PY - 1995/1/1/medline PY - 1995/1/1/entrez SP - 79 EP - 94 JF - Hematologic pathology JO - Hematol Pathol VL - 9 IS - 2 N2 - This study assesses the value of immunologic and ultrastructural methods in disclosing the lineage commitment of cells from acute leukemias (ALs). Two hundred and fifty-one ALs were characterized morphologically, cytochemically, and immunologically. Myeloperoxidase (MPO) positivity in > 3% of blasts was regarded as evidence of the myeloid origin of leukemic cells, cytoplasmic CD22 (cCD22) expression was taken as an indication for B-lineage acute lymphoblastic leukemia (ALL), and CD3+ (membrane or cytoplasmic) cases were classified as T-ALL. Diagnosis of minimally differentiated acute myeloid leukemia (AML-M0) was made when blast cells had undifferentiated features by light microscopy, reacted with at least one of the antibodies to myeloid-specific antigens (CD13, CD33, MPO), and lacked CD19, cCD22, and c/mCD3. Megakaryoblastic differentiation was demonstrated by the expression of CD41 and/or CD61. Following these criteria, 209 cases were classified as acute myeloid leukemia (AML) and 39 as ALL. Expression of lymphoid antigens was detected in 45% of AML cases and 30% of ALLs showed myeloid antigens. One case was regarded as a true biphenotypic leukemia because of the combined expression of MPO and CD33 for the myeloid lineage, and cCD3, CD2, and CD5 for the T-cell lineage. Two cases lacked signs of myeloid or lymphoid differentiation and were studied by electron microscopy methods. One displayed platelet peroxidase (PPO) activity and was classified as a megakaryoblastic variant, one other reacted with anti-CD33 and was considered AML-M0. We conclude that light microscopy and standard immunologic methods can accurately demonstrate the lineage orientation in greater than 99% of ALs. Integration with ultrastructural analysis can define the cell nature of virtually all cases of AL. SN - 0886-0238 UR - https://www.unboundmedicine.com/medline/citation/7559258/Lineage_identification_of_acute_leukemias:_relevance_of_immunologic_and_ultrastructural_techniques_ L2 - https://medlineplus.gov/leukemia.html DB - PRIME DP - Unbound Medicine ER -