Acute leukaemia types: Difference between revisions
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<div style="width: 95%; overflow: auto; border: 1px solid navy; font-size:100%"> | <div style="width: 95%; overflow: auto; border: 1px solid navy; font-size:100%"> | ||
{| 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;"| | !colspan="4" style = "font-size:110%; color: navy; text-align:center; background:#DEE0DE;"|'''Expression guide: acute myeloid leukaemia''' | ||
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!colspan="4" style = "font-size:90%; background:#DAE8F2"|'''CD45 | !colspan="4" style = "font-size:90%; background:#DAE8F2"|'''Expected expression of CD45 in AML''' | ||
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|colspan="4" style = "font-size:90%; color:black;" |'''[[CD45]]''' expression in AML is "weak" i.e. significantly less intense than normal T cells, B cells or monocytes. The typically 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. | |colspan="4" style = "font-size:90%; color:black;" |'''[[CD45]]''' expression in AML is "weak" i.e. significantly less intense than normal T cells, B cells or monocytes. The typically 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. | ||
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Atypical expression may be seen in [[APL]] and [[monocytic AML]] and occasionally other types | |||
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!colspan="3" style = "font-size:90%; background:#DAE8F2"|'''Markers of | !colspan="3" style = "font-size:90%; background:#DAE8F2"|'''Markers of primitive cell type frequently expressed in AML''' | ||
<div class="mw-collapsible mw-collapsed" data-expandtext="Click for explanation" data-collapsetext="Hide explanation"> | |||
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</br>AML cells often have markers that reflect thier primitive nature. They are absent in many cases, so are not required to identify blast cells if other features fit (weak CD45 and/or blast cell morphology), but detecting them can increase diagnostic confidence. In AML these markers are most frequently expressed by less differentiated types.</span></br> | |||
<span style="font-size:90%;>*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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|colspan="1" style = "font-size:80%; width: 4%; |'''Marker''' | |colspan="1" style = "font-size:80%; width: 4%; |'''Marker''' | ||
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|colspan="1" style = "font-size:90%; color:black;" |'''[[CD34]]''' | |colspan="1" style = "font-size:90%; color:black;" |'''[[CD34]]''' | ||
|colspan="1" style = "background:#006699;"| | |colspan="1" style = "background:#006699; color:white;"|>70% of cases | ||
|colspan="1" style = "font-size:84%;"|Frequently expressed, most often in less differentiated forms of AML. Expression | |colspan="1" style = "font-size:84%;"|Frequently expressed, most often in less differentiated forms of AML. Expression '''often less intense than in lymphoid leukaemias''' | ||
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|colspan="1" style = "width: 4%; font-size:90%; color:black;" |'''[[TDT]]''' | |colspan="1" style = "width: 4%; font-size:90%; color:black;" |'''[[TDT]]''' | ||
|colspan="1" style = "width: 8%; background:#66e0ff;"| | |colspan="1" style = "width: 8%; background:#66e0ff;"| | ||
|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%;"|Expressed particularly in less differentiated forms of AML. Often on a sub-population of cells; expression '''usually less intense than in lymphoid leukaemias.''' | ||
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|colspan="1" style = "font-size:90%; color:black;" |'''[[CD7]]''' | |colspan="1" style = "font-size:90%; color:black;" |'''[[CD7]]''' | ||
|colspan="1" style = "background:#00b8e6;"| | |colspan="1" style = "background:#00b8e6;"| | ||
|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: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'''. | ||
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!colspan="3" style = "font-size:90%; background:#DAE8F2"|'''Markers with very strong lineage specificity in AML''' | !colspan="3" style = "font-size:90%; background:#DAE8F2"|'''Markers with very strong lineage specificity in AML''' |
Revision as of 11:28, 18 July 2023
Expression guide: acute myeloid leukaemia | |||
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Expected expression of CD45 in AML | |||
CD45 expression in AML is "weak" i.e. significantly less intense than normal T cells, B cells or monocytes. The typically 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.
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Markers of primitive cell type frequently expressed in AML
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Marker | Expectation | Comment | |
CD34 | >70% of cases | 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 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 |