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Test and Acute leukaemia types: Difference between pages

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[[file:LPL.jpg|200px|link=LPL.jpg]] 
<span style="color: navy>'''Background to flow cytometric diagnosis'''</span>
These cells share features of mature B cell differentation with features of early plasma cell differentiation and may have mixed populations with features of each. Where either B-cell differentiation or plasma cell features predominate this can make the diagnosis difficult.
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{| class="wikitable" style="color:black; background-color:#ffffff;" cellpadding="5"
{| class="wikitable" style="color:black; background-color:#ffffff;" cellpadding="5"
!colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|'''Immunophenotype of LPL'''
!colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|Marker patterns in typical acute myeloid leukaemia
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|-
!colspan="4" style = "font-size:90%; background:#DAE8F2"|Major markers useful in CLL diagnosis
!colspan="4" style = "font-size:90%; background:#DAE8F2"|'''CD45 expression in AML'''
|-
|colspan="4" style = "font-size:90%; color:black;" |Expression of CD45 is "weak" i.e. significantly less intense than normal T cells, B cells or monocytes. The typically low side scatter means that myeloid blast cells tend to form a relatively uniform population separate from lymphocytes on CD45/SSc plots. However, there is some variability releted to indididual subtypes.
|-
!colspan="3" style = "font-size:90%; background:#DAE8F2"|'''Markers of pimitive cell type expected in AML'''
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!colspan="3" style = "font-size:90%; background:white"|These markers are generally regarded as indicating less differentiated cells, so may be expressed by any acute leukaemia type. When strongly expressed they have some value in indicating T or B lineage.
|-
|-
|colspan="1" style = "font-size:80%; width: 4%; |'''Marker'''
|colspan="1" style = "font-size:80%; width: 4%; |'''Marker'''
|colspan="1" style = "font-size:80%; width: 8%; |'''Freq'''
|colspan="1" style = "font-size:80%; width: 8%; |'''Expectation'''
|colspan="1" style = "font-size:80%; width: 8%; |'''Level'''
|colspan="1" style = "font-size:80%; width: 80%; |'''Comment'''
|colspan="1" style = "font-size:80%; width: 80%; |'''Comment'''
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|-
|colspan="1" style = "font-size:90%; color:black;" |CD19
|colspan="1" style = "font-size:90%; color:black;" |'''[[CD34]]'''
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Frequently expressed, most often in less differentiated forms of AML. Expression often '''less intense than in lymphoid leukaemias'''
|colspan="1" style = "font-size:84%;"|Generally CD19 will be expressed
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|-
|colspan="1" style = "width: 4%; font-size:90%; color:black;" |κ/λ
|colspan="1" style = "width: 4%; font-size:90%; color:black;" |'''[[TDT]]'''
|colspan="1" style = "width: 8%; background:#006699;"|
|colspan="1" style = "width: 8%; background:#66e0ff;"|
|colspan="1" style = "font-size:80%; width: 8%; |
|colspan="1" style = "font-size:80%;"|Expressed particularly in less differentiated forms of AML. Often on a sub-population of cells; expression usually less intense than in lymphoid leukaemias
|colspan="1" style = "font-size:80%;"|Light chain retriction usually detected
|-
|-
|colspan="1" style = "font-size:90%; color:black;" |CD5
|colspan="1" style = "font-size:90%; color:black;" |'''[[CD7]]'''
|colspan="1" style = "background:#66e0ff;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|Uncommon but seen in some cases
|-
|colspan="1" style = "font-size:90%; color:black;" |CD23
|colspan="1" style = "background:#00b8e6;"|
|colspan="1" style = "background:#00b8e6;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:80%;"|Similar to TdT, CD7 expression is recognised on a proportion of AML, usually those with less differentiated phenotype. Most consistently expressed in T-ALL.
|colspan="1" style = "font-size:84%;"|Infrequent but reported
|-
|-
|colspan="1" style = "font-size:90%; color:black;" |CD79b
!colspan="3" style = "font-size:90%; background:#DAE8F2"|'''Markers with strong lineage specificity in AML'''
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Generally expressed
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|-
|colspan="1" style = "font-size:90%; color:black;" |CD200
!colspan="3" style = "font-size:90%; background:white"|While not expressed by all cases, MPO can be considered to be lineage-defining marker in AML (or establishing myeloid lineage in MPAL).
|colspan="1" style = "background:#66e0ff;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Detected infrequently
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|-
|colspan="1" style = "font-size:90%; color:black;" |FMC7
|colspan="1" style = "font-size:80%; width: 4%; |'''Marker'''
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "font-size:80%; width: 8%; |'''Expectation'''
|colspan="1" style = "font-size:80%;"|
|colspan="1" style = "font-size:80%; width: 80%; |'''Comment'''
|colspan="1" style = "font-size:80%;"|Generally expressed
|-
|-
!colspan="4" style = "font-size:90%; background:#DAE8F2"|Other relevant markers
|colspan="1" style = "font-size:90%; color:black;" |'''[[CD34]]'''
|-
|colspan="1" style = "font-size:90%;" |CD10
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Frequently expressed, most often in less differentiated forms of AML. Expression often '''less intense than in lymphoid leukaemias'''
|colspan="1" style = "font-size:84%;"|Expression may be seen
|-
|colspan="1" style = "font-size:90%;" |CD11C
|colspan="1" style = "background:#006699;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|
|-
|colspan="1" style = "font-size:90%;" |CD20
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|Expect expression
|-
|colspan="1" style = "font-size:90%; color:black;" |CD25
|colspan="1" style = "background:#66e0ff;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|
|-
|colspan="1" style = "font-size:90%; color:black;" |CD38
|colspan="1" style = "background:#004466;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|
|-
|colspan="1" style = "font-size:90%;" |CD43
|colspan="1" style = "background:#66e0ff;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|
|-
|colspan="1" style = "font-size:90%;" |CD103
|colspan="1" style = "background:#E6FAFF;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|
|-
|colspan="1" style = "font-size:90%;" |CD138
|colspan="1" style = "background:#66e0ff;"|
|colspan="1" style = "font-size:80%;"|-
|colspan="1" style = "font-size:84%;"|
|-
|-
|}
|}
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</div>
<span style="color:navy;font-size:80% ">'''Key to table: '''</span>
<span style="font-size:80% ">Key to colour code for expression frequency [[Key_to_marker_expression_table|Click for link]]</span>
<span style="font-size:80% ">Key to expression strength code and use [[Expression strength key|Click for link]]</span>
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Revision as of 13:57, 17 July 2023

Marker patterns in typical acute myeloid leukaemia
CD45 expression in AML
Expression of CD45 is "weak" i.e. significantly less intense than normal T cells, B cells or monocytes. The typically low side scatter means that myeloid blast cells tend to form a relatively uniform population separate from lymphocytes on CD45/SSc plots. However, there is some variability releted to indididual subtypes.
Markers of pimitive cell type expected in AML
These markers are generally regarded as indicating less differentiated cells, so may be expressed by any acute leukaemia type. When strongly expressed they have some value in indicating T or B lineage.
Marker Expectation Comment
CD34 Frequently expressed, most often in less differentiated forms of AML. Expression often less intense than in lymphoid leukaemias
TDT Expressed particularly in less differentiated forms of AML. Often on a sub-population of cells; expression usually less intense than in lymphoid leukaemias
CD7 Similar to TdT, CD7 expression is recognised on a proportion of AML, usually those with less differentiated phenotype. Most consistently expressed in T-ALL.
Markers with strong lineage specificity in AML
While not expressed by all cases, MPO can be considered to be lineage-defining marker in AML (or establishing myeloid lineage in MPAL).
Marker Expectation Comment
CD34 Frequently expressed, most often in less differentiated forms of AML. Expression often less intense than in lymphoid leukaemias