Immunophenotyping Panels for the Diagnosis of Acute Promyelocytic Leukemia: Evolution and Diagnostic Capacity / 대한진단검사의학회지

ABSTRACT

BACKGROUND: Acute promyelocytic leukemia (APL) has two subtypes, a typical French-American-British (FAB)-M3 type and an atypical FAB-M3v type described as microgranular variant, and immunophenotyping is a rapid and accurate method for the diagnosis of APL. We tried to define immunological criteria for the diagnosis of APL in each different period from 1987 to 2003. The purpose of this study was to compare the discrimination capacity of several panels with FAB classification. METHODS: We applied immunophenotyping panel I, II, and III for the diagnosis of APL in each of the following three different periods Panel I [HLA-DR(-), CD15(-)] (1987-1991); Panel II [HLA-DR(-), CD13(+), CD33(+), CD14(-)] (1992-1994); and Panel III [HLA- DR(-), CD34(-), CD13(+), CD33(+), CD14(-)] (1994-2003) with negative lymphoid markers in all panels. Standard FAB classification and direct immunofluorescence method were applied to diagnosis in 570 cases of acute leukemia. RESULTS: The immunophenotyping to identify FAB subtype AML-M3 and M3v was established as the panel of [HLA-DR (-), CD34 (-), CD13 and/or CD33 (+), CD14 (-)] with negative lymphoid markers (CD19, CD10, CD20, CD22, CD3, CD5, and CD7). The sensitivity and specificity of this panel for the diagnosis of APL was 100% and 99%, respectively. CONCLUSIONS: Our study demonstrates the evolution of immunophenotyping panel from a primitive to advanced design. This immunophenotyping panel can be a "quick reference" for the diagnosis of APL without extra effort.