Acute leukaemia types: Difference between revisions
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!colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|''' | !colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|'''Marker expression guide: acute myeloid leukaemia''' | ||
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</br>AML cells often have markers that reflect their primitive nature. | </br>AML cells often have markers that reflect their primitive nature. | ||
'''(1)''' The typically low CD45 expression and low side scatter of most blast cells means that myeloid blast cells tend to form a relatively uniform population that is clearly separated from that of lymphocytes on CD45/SSc plots (please see [[CD45]]</br> | |||
*Other markers such as CD34, TdT and CD7 may be considered to reflect primitive differentiation, so while they are not required if other features fit (weak CD45 and/or blast cell morphology), | |||
*Other markers such as CD34, TdT and CD7 may be considered to reflect primitive differentiation, so while they are not required if other features fit (weak CD45 and/or blast cell morphology), | |||
*Note while not fully specific for any given lineage, some are more frequently associated with particular lineages so may contribute to lineage assignment in difficult cases (see comments). | *Note while not fully specific for any given lineage, some are more frequently associated with particular lineages so may contribute to lineage assignment in difficult cases (see comments). | ||
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Revision as of 18:47, 18 July 2023
Marker expression guide: acute myeloid leukaemia | |||
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Markers useful to confirm the primitive phenotype (expressed in both AML and ALL)
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Marker | Comment | ||
CD45 | Expressed by all leukocytes and precursors (100% of cases), but in AML expression is "weak" i.e. significantly less intense than normal T cells, B cells or monocytes. In monocytic AML expression may be stronger. | ||
CD34 | Frequently expressed by AML blast cells (40-80% of cases) - most often in less differentiated forms of AML. However, expression is less frequent and often less intense than in lymphoid leukaemias | ||
TDT | Expressed AML particularly in less differentiated blast cells, often on a sub-population of cells. More typically associated with ALL where expression is generally stronger. | ||
CD7 | Similar to TdT, although more frequent (20-40%) CD7 yend to be expressed by AML blasts in the more primitive forms. This marker is most consistently a marker of T-lineage (including T-ALL). | ||
Markers with very strong lineage specificity in AML | |||
While not expressed by all cases, when detected by flow cytomwtry MPO can be considered to be lineage-defining marker in AML (or establishing myeloid lineage in MPAL). | |||
Marker | Expectation | Comment | |
MPO | A strong lineage marker for AML when detected by flow cytometry (though potentially less so by immunocytochemistry) | ||
Lineage markers in AML that with relatively high speificity | |||
These markers are each expressed by many cases (around 80% for each marker), they have high specificity although abberrent expression in ALL is feequent (overall 10-20% for any individual marker)). | |||
Marker | Expectation | Comment | |
CD117 | One of tne of the first lineage-markers acquired in AML with good relative specificity | ||
CD33 | A good marker for AML that is often less strongly expressed in monocytic forms | ||
CD13 | A good lineage marker for AML aquired a little later, higher than CD13 in monocytic forms | ||
Other markers helpful in detecting myeloid lineage (often in AML subtypes) | |||
These markers have less general value in diagnosis, but can be useful in subtype selection or in cases whwere lineage is ambiguous. | |||
Marker | Expectation | Comment | |
CD10 | Gran | One of tne of the first lineage-markers acquired in AML with good relative specificity | |
CD11b | Gran | One of tne of the first lineage-markers acquired in AML with good relative specificity | |
CD11c | Mono | One of tne of the first lineage-markers acquired in AML with good relative specificity | |
CD14 | Mono | A good marker for AML that is often less strongly expressed in monocytic forms | |
CD64 | Mono | A good lineage marker for AML aquired a little later, higher than CD13 in monocytic forms |