Volume 14, Issue 3 ( September 2022 2022)                   Iranian Journal of Blood and Cancer 2022, 14(3): 22-31 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Koulmane Laxminarayana S L, Harrison A, Datari P V, Belurkar S V. Significance of Cross Lineage Antigen Expression in Acute Lymphoblastic Leukemia. Iranian Journal of Blood and Cancer 2022; 14 (3) :22-31
URL: http://ijbc.ir/article-1-1268-en.html
1- Associate Professor, Department of Pathology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal - 576104, KA, India.
2- Assistant Professor, Department of Pathology, Melaka Manipal Medical College, Manipal, Manipal Academy of Higher Education, Manipal - 576104, KA, India. , aradhanaharrison@gmail.com
3- Former Post graduate student, Department of Pathology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal - 576104, KA, India.
4- Additional Professor, Department of Pathology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal - 576104, KA, India.
Abstract:   (921 Views)

Background: Aberrant expression of cross-lineage antigens gives valuable insight into the diagnosis and prognosis of acute leukemia. In countries like India, cytogenetic tests are widely accessible. Exploring the prognostic value of an accessible test is of great importance. Therefore, establishing a population-specific immunophenotype database will enable to design an antibody panel equipped to detect cross-lineage antigen expression. The aim of this study was to determine the frequencies of cross-lineage antigen expression in Acute Lymphoblastic Leukaemia (ALL), its relationship with clinical features, and changes in blood counts during the treatment course.
Methods: This was a retrospective observational study conducted at a tertiary care hospital. Consecutive ALL cases over 2 years were reviewed. Relation of cross-lineage aberrant antigens with blood counts and clinical features were studied. Chi-square test and Fisher’s exact test were used.
Results: A total of 149 ALL cases were included in the study. Thirty (20.1%) cases showed expression of cross-lineage antigens. CD7 was the most commonly expressed cross-lineage antigen, seen in 14 (10.5%) cases of B-ALL. CD13, seen in eight (5.3%) patients, was the most frequent aberrant myeloid antigen. Myeloid aberrancies were associated with lower WBC count and blast count while aberrancies of T-cell antigens on B-ALL showed higher WBC count and blast count.
Conclusions: Cross lineage antigenic aberrancies influence blast count and WBC count. Documentation of these aberrancies in ALL helps in prognostication and monitoring of the disease.

Full-Text [PDF 842 kb]   (408 Downloads)    
: Original Article | Subject: Adults Hematology & Oncology
Received: 2022/06/7 | Accepted: 2022/08/12 | Published: 2022/09/19

1. Ossenkoppele GJ, van de Loosdrecht AA, Schuurhuis GJ. Review of the relevance of aberrant antigen expression by flow cytometry in myeloid neoplasms. Br J Haematol. 2011 May;153(4):421-36. [DOI:10.1111/j.1365-2141.2011.08595.x]
2. Peters JM, Ansari MQ. Multiparameter flow cytometry in the diagnosis and management of acute leukaemia. Arch Pathol Lab Med. 2011 Jan;135(1):44-54. [DOI:10.5858/2010-0387-RAR.1]
3. Jalal SD, Al-Allawi NAS, Al Doski AAS. Immunophenotypic aberrancies in acute lymphoblastic leukemia from 282 Iraqi patients. Int J Lab Hematol. 2017 Dec;39(6):625-632. [DOI:10.1111/ijlh.12716]
4. Cherian S, Hedley BD, Keeney M. Common flow cytometry pitfalls in diagnostic hematopathology. Cytometry B Clin Cytom. 2019 Nov;96(6):449-463. Epub 2019 Nov 7. [DOI:10.1002/cyto.b.21854]
5. Bagg A. Lineage ambiguity, infidelity, and promiscuity in immunophenotypically complex acute leukemias: genetic and morphologic correlates. Am J Clin Pathol. 2007 Oct;128(4):545-8. [DOI:10.1309/NQQQY37HPDNAMC1Y]
6. Lopes TC, Andrade KN, Camelo NL, et al. Influence of aberrant myeloid expression on acute lymphoblastic leukemia in children and adolescents from Maranhão, Brazil. Genet Mol Res. 2014 Dec 4;13(4):10301-7. [DOI:10.4238/2014.December.4.25]
7. Liu J, Tan X, Ma YY, et al. Study on the Prognostic Value of Aberrant Antigen in Patients With Acute B Lymphocytic Leukaemia. Clin Lymphoma Myeloma Leuk. 2019;19:349-58. [DOI:10.1016/j.clml.2019.03.012]
8. Supriyadi E, Veerman AJ, Sutaryo, et al. Myeloid Antigen Expression in Childhood Acute Lymphoblastic Leukemia and Its Relevance for Clinical Outcome in Indonesian ALL-2006 Protocol. J Oncol. 2012;2012:135186. [DOI:10.1155/2012/135186]
9. Al-Zaabi M, Al-Khabori M, Fawaz N, et al. Impact of Aberrant Myeloid Antigen Expression on Outcomes of Patients with T-cell Acute Lymphoblastic Leukemia. Oman Med J. 2017 May;32(3):189-193. [DOI:10.5001/omj.2017.36]
10. Suggs JL, Cruse JM, Lewis RE. Aberrant myeloid marker expression in precursor B-cell and T-cell leukemias. Exp Mol Pathol. 2007 Dec;83(3):471-3. [DOI:10.1016/j.yexmp.2007.08.012]
11. Sobol-Milejska G, Mizia-Malarz A, Wos H. Expression of myeloid antigens on lymphoblast surface in childhood acute lymphoblastic leukemia at diagnosis and its effect on early response to treatment: a preliminary report. Int J Hematol. 2013 Sep;98(3):331-6. [DOI:10.1007/s12185-013-1397-6]
12. Putti MC, Rondelli R, Cocito MG, et al. Expression of myeloid markers lacks prognostic impact in children treated for acute lymphoblastic leukemia: Italian experience in AIEOP-ALL 88-91 studies. Blood. 1998 Aug 1;92(3):795-801. [DOI:10.1182/blood.V92.3.795.415k01_795_801]
13. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al, editors. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th Ed. Lyon: International Agency for Research on Cancer; c2017.
14. Abdulateef NA, Ismail MM, Aljedani H. Clinical significance of co-expression of aberrant antigens in acute leukemia: a retrospective cohort study in Makah Al Mukaramah, Saudi Arabia. Asian Pac J Cancer Prev. 2014;15(1):221-7. [DOI:10.7314/APJCP.2014.15.1.221]
15. Zhang YD, Tan LN, Hu Q, et al. Immunophenotyping and its clinical significance in childhood acute lymphoblastic leukemia. Zhongguo Dang Dai Er Ke Za Zhi. 2012 Mar;14(3):188-91. [Article]
16. Sharma M, Sachdeva MU, Varma N, et al. Characterization of immunophenotypic aberrancies in adult and childhood acute lymphoblastic leukemia: A study from Northern India. J Cancer Res Ther. 2016 Apr-Jun;12(2):620-6. [DOI:10.4103/0973-1482.147716]
17. Cézar RS, Cerqueira BA, da Paz Sde S, et al. Outcome of B-Cell Acute Lymphoblastic Leukemia in Brazilian Children: Immunophenotypical, Hematological, and Clinical Evaluation. J Pediatr Hematol Oncol. 2015 Aug;37(6):423-8. [DOI:10.1097/MPH.0000000000000358]
18. Mazher N, Malik N, Imran A, et al. Aberrant Expression of CD Markers in Acute Leukaemia. Ann. Pak. Inst. Med. Sci. 2013;9:99-102. [Article]
19. Amirghofran Z, Daneshbod Y, Gholijani N, et al. The Influence of Bcl-2 and Myeloid Antigen Expression on Response to Therapy in Childhood Acute Lymphoblastic Leukaemia. Archives of Iranian Medicine. 2011;14:170. [Article]
20. Shahni A, Saud M, Siddiqui S, et al. Expression of aberrant antigens in hematological malignancies: A single center experience. Pak J Med Sci. 2018 Mar-Apr;34(2):457-462. [DOI:10.12669/pjms.342.13996]
21. Sharma RK, Purohit A, Somasundaram V, et al. Aberrant myeloid antigen co-expression is correlated with high percentages of CD34-positive cells among blasts of acute lymphoblastic leukaemia patients: an Indian tertiary care center perspective. Blood Res. 2014;49(4):241-5. [DOI:10.5045/br.2014.49.4.241]
22. Dalal BI, Al Mugairi A, Pi S, et al. Aberrant expression of CD13 identifies a subgroup of standard-risk adult acute lymphoblastic leukaemia with inferior survival. Clin Lymphoma Myeloma Leuk. 2014;14:239-44. [DOI:10.1016/j.clml.2013.10.003]
23. Vitale A, Guarini A, Ariola C, et al. Absence of prognostic impact of CD13 and/or CD33 antigen expression in adult acute lymphoblastic leukemia. Results of the GIMEMA ALL 0496 trial. Haematologica. 2007 Mar;92(3):342-8. [DOI:10.3324/haematol.10385]
24. Ibrahim AM, Hameed BM. Prognostic value of myeloid antigens expression in childhood acute lymphoblastic leukaemia. Iraqi J Haematol. 2017 May;6:12-6. [DOI:10.4103/ijh.ijh_5_17]
25. Bhushan B, Chauhan PS, Saluja S, et al. Aberrant phenotypes in childhood and adult acute leukemia and its association with adverse prognostic factors and clinical outcome. Clin Exp Med. 2010 Mar;10(1):33-40. [DOI:10.1007/s10238-009-0067-8]
26. Sarma A, Hazarika M, Das D, et al. Expression of aberrant CD markers in acute leukemia: a study of 100 cases with immunophenotyping by multiparameter flowcytometry. Cancer Biomark. 2015;15(4):501-5. [DOI:10.3233/CBM-150482]
27. Garg N, Kotru M, Kumar D, et al. Correlation of expression of aberrant immunophenotypic markers in T-ALL with its morphology: A pilot study. J Lab Physicians. 2018 Oct-Dec;10(4):410-413. [DOI:10.4103/JLP.JLP_35_18]
28. Rodríguez-Rodríguez S, Pomerantz A, Demichelis-Gómez R, et al.e Impact of Aberrant Antigens in the Outcome of Patients with Acute Leukaemia at a Referral Institution in Mexico City. Rev Invest Clin. 2016;68:305-13. [Article]
29. Seegmiller AC, Kroft SH, Karandikar NJ, et al. Characterization of immunophenotypic aberrancies in 200 cases of B acute lymphoblastic leukemia. Am J Clin Pathol. 2009 Dec;132(6):940-9. [DOI:10.1309/AJCP8G5RMTWUEMUU]
30. Lenkei R, Björk O, Ost A, et al. Expression of CD15 as predictor of relapse in children with acute lymphoblastic leukaemia of the pre-B type. Leuk Res. 1991;15:189-94. [DOI:10.1016/0145-2126(91)90120-I]
31. Hussein S, Gill KZ, Sireci AN, et al. Aberrant T-cell antigen expression in B lymphoblastic leukaemia. Br J Haematol. 2011 Nov;155(4):449-56. [DOI:10.1111/j.1365-2141.2011.08870.x]
32. Paietta E, Neuberg D, Richards S, et al. Rare adult acute lymphocytic leukemia with CD56 expression in the ECOG experience shows unexpected phenotypic and genotypic heterogeneity. Am J Hematol. 2001 Mar;66(3):189-96. [DOI:10.1002/1096-8652(200103)66:33.0.CO;2-A]

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 All Rights Reserved | Iranian Journal of Blood and Cancer

Designed & Developed by : Yektaweb