A Clinicopathological Correlation of Acute Leukaemias in relation to Immunophenotyping and Cytogenetics

Introduction: Leukemia accounts for 0.15 – 0.6% of the total medical admissions in many general hospitals in India. Frequency of leukemia seen in India of Acute Myeloid leukaemia (AML) is 20 - 25% and Acute Lymphoblastic leukaemia (ALL) is 15-25%. The Annual incidence rate of AML and ALL are 5.6 and 30.9 per million population respectively.

Aims: To study the clinicopathological correlation in Acute myeloid and Acute Lymphoblastic leukaemias in relation to immunophenotyping and cytogenetics.

Materials & Methods: All newly diagnosed cases of acute myeloid leukaemia that presented to our hospital from January 2007 to July 2009 were included in this study. The peripheral blood and bone marrow were tested for surface membrane, cytoplasmic and nuclear antigens and were classified by the French-American- British (FAB) Cooperative Group Classification by using Romanowsky (Leishman and May Grunwald Giemsa[MGG]) stained smears and cytochemical stains.

Results & Summary: A series of available 100 cases of Acute Leukemia diagnosed during a period of 30 months (January 2007 to July 2009) were reviewed and various clinical, biochemical, immunophenotypic and cytogenetic parameters were assessed. 88 cases were subject to immunophenotyping and 60 cases were subject to cytogenetic analysis either by conventional Karyotyping, FISH (fluorescence in situ hybridization) and RT-PCR (Reverse transcriptase polymerase chain reaction). The antigen expressions by immunophenotype in acute myeloid and lymphoblastic leukemias were compared with age, Haemoglobin, Total WBC count, Platelet counts, Lactate dehydrogenase levels and abnormal karyotypes. Analytical statistics showed a significant correlation in the expressions of CD13, CD33, CD117 and CD64 in Acute Myeloid Leukemia and CD10, CD19, CD20 and CD22 in Acute Lymphoblastic leukemia and the expressions of CD13/CD117, CD3/CD10/CD22,CD3/CD5/CD2 and CD117/CD11c were related to the age, Haemoglobin, WBC count and Lactate dehydrogenase levels respectively (p<0.05)

Conclusion: We assessed the role of immunophenotyping and cytogenetics and their clinicopathological correlation with various haematological and biochemical parameters and found a statistically significant correlation with various parameters and supported expression of certain antigens and abnormal karyotypes correlate with a poor prognosis in Acute leukemias.

Author(s): Sunil Pazhayanur Venkateswaran , Annie Jojo , Geeta Vidhyadharan , Manoj Unni

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