Acute leukaemia types
From haematologyetc.co.uk
MARKERS USEFUL TO CONFIRM PRIMITIVE NATURE OF BLAST CELLS | |
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Markers frequently helpful
(1) Typically AML blasts have low CD45 expression and cause low side scatter. This means that they form a relatively uniform and distinctive population that is clearly separate from that of lymphocytes on CD45/SSc plots (for further details see this section) also not all AML forms may fit this pattern - particularly APL and monocytic AML. (2) Additional markers often expressed on myeloid cells may help confirm the primitive nature of the cells: in AML this is most often CD34, although other markers may contribute. | |
CD45 | Expressed leukocytes and their precursors; in AML expression is "weak" i.e. significantly less intense than normal lymphocytes 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. Although expression is also frequent (and often stronger) in ALL |
Markers helpful in some cases
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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 primitive ALL blast cells. |
CD7 | Predominantly seen as a T-cell antigen, CD7 tends may be expressed by AML blasts (20-40%) where it most often indicates a more primitive forms or MPAL. CD7 is most consistently a marker of T-lineage (including T-ALL and more mature froms). |
MARKERS USEFUL TO CONFIRM MYELOID LINEAGE OR DIFFERENTIATION | |
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Frequently expressed myeloid markers
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MPO | A strong lineage marker for AML (expressed in around 80% of cases) but generally in those with granulocytic maturation. When detected by flow cytometry is diagnostic of myeloid differentiation (either AML or MPAL) |
CD117 | An early marker of myeloid lineage, seen in up to 80% of AML and vauable in recognising more primitive differentaiion forms (aberrant expression in up to 20% of ALL) |
CD33 | A good marker for AML, particularly with granulocytic maturation, but often less strongly expressed in AML with monocytic dfferentiation. |
CD13 | A good lineage marker for AML that is acquired a little later in differentation than CD117 or CD33; expression of CD13 is often higher than CD13 in AML with monocytic differentiation. |
Markers of AML subtype
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Granulocytic lineage markers | |
CD10 | One of tne of the first lineage-markers acquired in AML with good relative specificity |
CD11b | One of tne of the first lineage-markers acquired in AML with good relative specificity |
Monocytic lineage markers | |
CD11c | One of tne of the first lineage-markers acquired in AML with good relative specificity |
CD14 | A good marker for AML that is often less strongly expressed in monocytic forms |
CD64 | A good lineage marker for AML aquired a little later, higher than CD13 in monocytic forms |
MARKERS USEFUL TO CONFIRM MYELOID LINEAGE OR DIFFERENTIATION | |
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Frequently expressed myeloid markers
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MPO | A strong lineage marker for AML (expressed in around 80% of cases) but generally in those with granulocytic maturation. When detected by flow cytometry is diagnostic of myeloid differentiation (either AML or MPAL) |
CD117 | An early marker of myeloid lineage, seen in up to 80% of AML and vauable in recognising more primitive differentaiion forms (aberrant expression in up to 20% of ALL) |
CD33 | A good marker for AML, particularly with granulocytic maturation, but often less strongly expressed in AML with monocytic dfferentiation. |
CD13 | A good lineage marker for AML that is acquired a little later in differentation than CD117 or CD33; expression of CD13 is often higher than CD13 in AML with monocytic differentiation. |
Markers of AML subtype
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Granulocytic lineage markers | |
CD10 | One of tne of the first lineage-markers acquired in AML with good relative specificity |
CD11b | One of tne of the first lineage-markers acquired in AML with good relative specificity |
Monocytic lineage markers | |
CD11c | One of tne of the first lineage-markers acquired in AML with good relative specificity |
CD14 | A good marker for AML that is often less strongly expressed in monocytic forms |
CD64 | A good lineage marker for AML aquired a little later, higher than CD13 in monocytic forms |