Aberrant expression of CD markers in AML in patients attending RIMS, Ranchi - An observational study.

Introduction: Acute myeloid leukaemia (AML) is a tumour of hematopoietic progenitors caused by acquired oncogenic mutations that impede differentiation, leading to the accumulation of immature myeloid blasts in the marrow. Aberrant phenotype is a phenomenon in which lymphoid-associated and other myeloid lineage markers are expressed in myeloblasts or myeloid-associated markers are expressed in lymphoblasts. Materials and Methods: Diagnosed cases of AML were included in this study to study the aberrant expression using multiparametric flow cytometry. Results: Out of a sample size of 50, 30 cases expressed aberrant CD markers. Male: Female ratio was 0.76. Majority of cases belonged to the age group >60 years of age. CD 7 was overall the most common aberrant CD marker. Conclusion: Immunophenotyping has a significant role in diagnosis and predicting prognosis of hematopoietic malignancies in the absence of more advanced diagnostic tools like cytogenetics.

Evaluation of Acute Leukaemias by Flow Cytometry and Its Correlation With Diagnosis Using Morphological and Special Staining Techniques.

BACKGROUND: Leukaemia can be reliably diagnosed and classified by the simultaneous application of multiple techniques. Cytochemical stains that are cheap and do not require any special instruments are very important in developing countries for the diagnosis of acute leukaemia (AL). AIM: To diagnose AL in all suspected cases by flow cytometry and to correlate the diagnosis with morphological and special staining like myeloperoxidase (MPO) and periodic acid-Sciff (PAS) techniques.  Methods and materials: The study participants' peripheral blood smear details and bone marrow aspirate smear morphologic findings, as well as socio-demographic information, were taken from the patients' medical files. In total, 57 newly diagnosed instances of acute leukaemia confirmed by flow cytometry were incorporated into the study, which underwent cytochemical labeling and morphological diagnosis. All patients who gave previous consent had their bone marrow aspirated, and a Wright-stained smear was produced for microscopic inspection, cytochemical staining, and immunophenotyping. In an ethylenediaminetetraacetic acid (EDTA) container, peripheral blood was also drawn for the same purpose. During the entire bone marrow smear examination, we used both MPO and PAS staining techniques. RESULTS:  The study was carried out between July 2019 and June 2020. Out of 57 cases in the study, 29 (50.9%) cases on cytochemical analysis of leukaemia using PAS and MPO were diagnosed with acute myeloid leukaemia (AML) and 28 (49.1%) were diagnosed as acute lymphoid leukaemia (ALL). Cytochemical analysis of leukaemia using PAS and MPO rendered the diagnosis in 92.9% of acute leukaemia cases in our study. A total of 25 out of 25 AML cases and 28 out of 32 cases of ALL were correctly diagnosed based on morphology and cytochemical staining. Morphology and cytochemical analysis alone were unable to correctly diagnose a total of four ALL cases. All AML cases that were wrongly diagnosed as ALL were mostly M0 and M1-AML. CONCLUSION: Morphological staining diagnosis by itself is capable of correctly identifying a large proportion of cases of AL, which comprised 92.98% of total cases. There was also a favorable relationship between findings of diagnosis by flow cytometry and findings of diagnosis by morphology assessment in determining acute leukaemias.

Utility of Flow Cytometry in Diagnosis of Acute Leukemias: A Study at RIMS, Ranchi, India.

Introduction: Leukemia is a neoplastic disorder originating in a hematopoietic cell that has undergone an intrinsic change, causing it to escape from the normal restraints imposed on proliferative activity. Immunophenotyping is now the preferred method for diagnosing, classifying, staging and monitoring the disease progression as well as response to therapy. Material and Method: The material of the present study consisted of 51 patients suffering from hematological malignancies who attended and /or were admitted in Rajendra Institute of Medical Sciences, Ranchi during the period from March 2018 to August 2019. Results: A total of 51 cases were diagnosed as acute leukemia on microscopic examination. On immunophenotyping, 36 cases (70.6%) were diagnosed as Acute Myeloid Leukemia (AML), 15 cases (29.4%) were diagnosed as Acute Lymphoblastic Leukemia (ALL). ALL cases were further divided into B-Cell ALL and T-Cell ALL with 8 cases (15.7%) and 7 cases (13.7%) respectively. Cytogenetics could not be done for these cases due to non-availability of the set-up for the same at the institute. Conclusion: Flowcytometry can be a great tool in diagnosis and categorisation of leukemia especially at centres where cytogenetics is not available.