Simultaneous or sequential expression of lymphoid and myeloid phenotypes in acute leukemia

Pb, Neame; Soamboonsrup, Praniti; Browman, George P.; Barr, RD; Saeed, N; Chan, Betty; Pai, Muktha R; Benger, Ann; Wilson, William E.; Walker, IR

doi:10.1182/blood.v65.1.142.142

Cited by 115 publications

(15 citation statements)

References 37 publications

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“…About 20% of Samples showed a slight, limited deviation from the expected antigen constellation (pattern B). These cases are to be operationally considered unambiguous and diagnosable, although, according to a biological point of view, previous studies termed similar phenotypes as "lineage infidelities" or "acute mixed lineage leukemias" [ 13,15,. We believe that our classification may provide a positivity; white areas indicate ectopic antigen expression.…”

Section: Discussionmentioning

confidence: 87%

“…It is now accepted that immunophenotypic analysis of leukemic cells have an impact on routine diagnostic screening in hematology laboratories, making a critical contribution to the final diagnosis in about 20% of cases and playing an useful confirmatory role in all the remaining cases [4-51. However, although immunological typing is now reaching a stage of general acceptance of its 0 1989 Alan R. Liss, Inc. ability to diagnose accurately acute leukemia [6-111, several difficulties still prevent the successful application of such a new tool in a number of hematology laboratories. Major complications are related to the progressive identification of complex or unexpected leukemic surface membrane mosaics [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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Immunodiagnosis of acute leukemia displaying ectopic antigens: Proposal for a classification of promiscuous phenotypes

Vecchio¹,

Schiavone

Ferrara³

et al. 1989

American J Hematol

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The nature of the blast cells in 163 cases of acute leukemia was investigated by immunophenotyping, with particular emphasis on the expression of "ectopic" surface membrane structures. Although no antigen included in our panel except CD3 revealed absolute lineage restriction, immunological typing allowed a definite characterization of blast cells in more than 90% of cases. Four groups of patients were identified (A, B, C, D) with different degrees of antigen ectopic expression. We classified as group A leukemias (74%) those expressing conventional antigenic patterns, in absence of cross-lineage markers. Samples classified as group B (18%) showed a single ectopic membrane specificity, apparently discordant with the overall composite phenotype; such a "low-grade deviation" did not prevent a definite immunodiagnosis. Pattern C specimens (5%) revealed a promiscuous coexpression of markers related to different lineages (biphenotypic leukemias), whereas group D included unclassifiable phenotypes, characterized by no antigen or DR-only expression. Our findings suggest the possibility of interpreting complex phenotypic constellations of membrane markers in a consistent and logical manner.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Immunodiagnosis of acute leukemia displaying ectopic antigens: Proposal for a classification of promiscuous phenotypes

Vecchio¹,

Schiavone

Ferrara³

et al. 1989

American J Hematol

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“…It was of particular interest that 6 of 9 MNC cxtracts from bone marrow and 2 of 3 MNC extracts from blood obtained lrom patients with undifferentiated leukemia (AUL) or acute leukemia (AL) were TdT-positive. Others have reported TdT-positive AUL/AL patients using the polymerase and immunofluorescence assays (14,20,23,28,38). These patients may be classified as myeloid or lymphoid (23) or express both cell types (38).…”

Section: Discussionmentioning

confidence: 99%

“…Others have reported TdT-positive AUL/AL patients using the polymerase and immunofluorescence assays (14,20,23,28,38). These patients may be classified as myeloid or lymphoid (23) or express both cell types (38). Some TdT-positive AUL/AL patients have been successfully treated with lymphoid drug regimens (35) while others have not (33).…”

Section: Discussionmentioning

confidence: 99%

Solid‐Phase enzyme immunoassay for terminal deoxynucleotidyl transferase (abbott tdt‐eia) in extracts of whole blood and mononuclear cells isolated from bone marrow and blood

Fairbanks

King

Colemán

et al. 1987

Clinical Laboratory Analysis

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The Abbott enzyme immunoassay for detecting terminal transferase (TdT-EIA) was evaluated at four institutions. Extracts of mononuclear cells isolated from bone marrow and peripheral blood of individuals with leukemic and nonleukemic diseases were assayed. In addition, whole blood specimens, in which TdT was extracted from mononuclear cells directly in blood, were assayed. Intrarun, interrun, and between laboratory coefficients of variation ranged from 6.2%-9.3%, 9.4%-11.1%, and 10.9-13.5%, respectively. Since TdT quantitation in whole blood extracts might be adversely affected by blood components and exogenous substances, studies were carried out to determine whether the TdT-EIA accurately measured TdT in blood. TdT recovery was virtually 100% in blood extracts provided that an extraction buffer, included in the TdT-EIA kit, was used. Addition of lipids, human gamma globulin, bilirubin, bacterial DNA polymerase, and chemotherapeutic drugs commonly used to treat acute lymphocytic leukemia had no effect on TdT antigenic activity in whole blood specimens. Linear regression analysis at two institutions comparing TdT quantitation using the TdT-EIA and DNA polymerase assays yielded correlation coefficients of 0.88 and 0.92. Assay results from 1,019 clinical specimens were used to establish expected values for extracts of whole blood and isolated mononuclear cells from blood and bone marrow. The data demonstrate that the TdT-EIA is a reproducible assay for quantitating TdT levels in clinical specimens.

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“…1977). In human, the existence of such common stem cells was suggested from the occurrence of simultaneous or sequential expression of lymphoid and myeloid phonotypes in acute leukemia (Neame et al, 1985). Recently, sIg + B1 + (B-cells) have been identified in human pluripotent hematopoietic colonies (Fauser et af., 1985).…”

Section: Discussionmentioning

confidence: 99%

Phenotypic characterization of ‘non‐T, non‐B’ acute lymphoblastic leukemia by a new panel (BL) of monoclonal antibodies

Al‐Katib

Wang

Bardales

et al. 1985

Hematological Oncology

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Peripheral blood and/or bone marrow leukemic cell suspensions from 49 patients with 'non-T, non-B' acute lymphoblastic leukemia (ALL) were analysed by flow cytometry using a new panel of four monoclonal antibodies. Anti-BL1 and anti-BL2 originating from NALM-6 and B35M lymphoblastoid cell lines, respectively. These antibodies recognize B-cell differentiation antigens: a heat stable non-immunoprecipitable antigenic determinant, and a 68 000 daltons glycoprotein molecule, respectively. BL5 and BL6 were derived by immunization with the promyelocytic cell line HL-60, recognizing antigens present on early hematopoietic cells: an 85 000 daltons MW glycoprotein (Pro-Im 1) and a heat stable antigen (Pro-Im2), respectively. All ALL patients studied had L1 or L2 morphology by the FAB classification and a blast count exceeding 50 per cent. There were 25 males and 24 females. Median age was 8 years (range 1-67 years). Thirty-nine cases were studied at initial presentation and 10 at relapse. Cells from 46/49 cases expressed BL2 and/or BL1, but were not reactive with BL5 or BL6. Three of 49 cases did not express BL1 or BL2. However, a small percentage of blasts from one case was positive for BL5 (13 per cent) and the other 2 cases were reactive with BL6 (20 per cent and 36 per cent, respectively). These were one adult and 2 pediatric patients that had other ALL markers and achieved a complete remission with appropriate ALL therapy. One of the BL6+ cases relapsed after 19 months with a change in phenotype to BL1+ BL2+ BL5- BL6-. This analysis shows that the majority of 'non-T, non-B' ALL's do express B-cell associated antigens (BL1/BL2) argumentative of their B-cell origin. A small subgroup does not express such antigens and may arise from a more immature cell, since they expressed antigens on early hematopoietic stem cells.

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Simultaneous or sequential expression of lymphoid and myeloid phenotypes in acute leukemia

Cited by 115 publications

References 37 publications

Immunodiagnosis of acute leukemia displaying ectopic antigens: Proposal for a classification of promiscuous phenotypes

Immunodiagnosis of acute leukemia displaying ectopic antigens: Proposal for a classification of promiscuous phenotypes

Solid‐Phase enzyme immunoassay for terminal deoxynucleotidyl transferase (abbott tdt‐eia) in extracts of whole blood and mononuclear cells isolated from bone marrow and blood

Phenotypic characterization of ‘non‐T, non‐B’ acute lymphoblastic leukemia by a new panel (BL) of monoclonal antibodies

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