MPAL: Difference between revisions
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<span id="anchor_0"></span>. | Final lineage in MPAL requires integration of additional molecular features, so assigments made by flow should be regarded as "provisional" pending full molecular assessment. | ||
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Revision as of 10:47, 27 July 2023
Final lineage in MPAL requires integration of additional molecular features, so assigments made by flow should be regarded as "provisional" pending full molecular assessment.
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Lineage assignments 1 - defining Myeloid lineage in MPAL
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Myeloid markers option 1 | |
Myeloperoxidase (MPO) | This marker alone is sufficient to establish myeloid lineage provided it meets the intensity definition - intensity should be at least half of that of mature neutrophils in at least of proportion of cells. |
Myeloid markers option 2 | |
If MPO does not meet criteria for myeloid lineage, then myeloid lineage may still be assigned through demonstration of monocytic lineage. This can be assigned by the detection of at least two of the following features: | |
Surface markers of monocytic lineage: CD11c, CD14, CD64 or other recognised features of monocytic differentiation: serum or urinary lysozyme or non-specific esterase (detected by enzyme cytochemistry) |
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Lineage assignments 2 - defining B-lymphoid lineage in MPAL
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Marker combination 1 | |
Required Strong expression of CD19 | To meet the definition of "strong" the expression intensity must exceed that of 50% of normal B lymphocytes |
In addition: CD10, CD22, or CD79a | If CD19 is strong then B-lineage can be assigned if there is at least ONE of these additional markers |
Marker combination 2 | |
Required Weak expression of CD19 | To meet the definition of "weak" the expression intensity must be less than that of 50% of normal B lymphocytes |
In addition: CD10, CD22, or CD79a | If CD19 is strong then B-lineage can be assigned if there is at least TWO of these additional markers |
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Lineage assignments 3 - defining T-lymphoid lineage in MPAL
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Marker combination 1 | |
Either Strong expression of CD3 on cell surface or cytoplasm | To meet the definition of "strong" the expression intensity must exceed that of 50% of normal T lymphocytes |
Or Immunocytochemistry positive for CD3 | It is important that this is established using a non-zeta chain reagent |