Acute leukaemia types: Difference between revisions
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!colspan="3" style = "font-size:90%; background:#DAE8F2"|'''Markers useful to confirm the primitive phenotype''' (expressed in both AML and ALL) | !colspan="3" style = "font-size:90%; background:#DAE8F2"|'''Markers useful to confirm the primitive phenotype''' (expressed in both AML and ALL) | ||
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Revision as of 18:57, 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)
(2) Other markers such as CD34, TdT and CD7 are expressed by "primitive cells" and can help increase diagnostic confidence that blast cells are present - although their presence is not required if other features fit. (3) While not fully specific for any given lineage, in some cases particular primitive markers are more frequently associated with particular lineages so may contribute to lineage assignment in difficult cases (see comments).
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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 in some cases of AML (5-20%) 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 |