Comparıson of Flow Cytometry Results of Acute Myeloid Leukemia Patients at Diagnosis and Relapse

Yıl 2020, Cilt: 42 Sayı: 4, 404 - 411, 13.07.2020

Eren Gunduz Hava Uskudar Teke Neslihan Andic

https://doi.org/10.20515/otd.556591

Öz

In most patients with acute
myeloid leukemia (AML), leukemic cells become undetectable after chemotherapy.
Nevertheless, leukemia may subsequently relapse due to minimal residual disease
(MRD). Flow cytometric monitoring of MRD is prognostically informative. However
immunophenotypic shifts at relapse is possible and may limit flow cytometric
MRD-testing. Our objective was to evaluate the antigen changes in our AML
patients. Patients diagnosed between September 2002 and November 2016 were
analyzed retrospectively. Bone marrow samples were collected at diagnosis and
relapse from 40 patients with de novo (n=34) or secondary (n=6) AML, aged 19 to
77 years. Bone marrow samples were collected into tubes containing K3EDTA.
Phycoerhtyrine (PE) and fluorescein isothiocyanate (FITC) (eBioscience and BD
Bioscience, San Jose, California) surface antigens were used according to the
routine panel used in our laboratory. Analyses were done according to CD45 SSC
gating strategy by Becton Dickinson FACSCalibur device. Overall, 34 of 40 (85%)
cases showed changes (gain and/or loss of antigen) of at least one marker
(n=10). Antigen changes were observed in 2 (n=7), 3 (n=6), 4 (n=6), 5 (n=4) or
6 (n=1) antigens in other patients. Antigen changes were found in 16 of 18
antigens (88.9%) totally. CD20 and CD45 were the only antigens with no change.
Patients with AML demonstrate a high frequency of immunophenotypic shift at
relapse. Antigen changes at relapse should be kept in mind in the minimal
residual disease era.

Anahtar Kelimeler

acute myeloid leukemia; flow cytometry; relapse; minimal residual disease

Akut Miyeloid Lösemili Hastaların Tanı ve Relaps Dönemindeki Akım Sitometri Sonuçlarının Karşılaştırılması

Öz

Akut miyeloid lösemi (AML)li çoğu
hastada lösemik hücreler kemoterapi sonrası 
kaybolur. Ancak minimal kalıntı hastalık (MKH) nedeniyle lösemi nüksü
gözlenebilir. MKH’nin akım sitometrik olarak takibi prognostik açıdan bilgi
sağlar. Fakat relaps anında immünfenotipik kaymalar olabilir ve akım sitometri
ile MKH değerlendirilmesini kısıtlayabilir. Bu çalışmada AML hastalarındaki
antijen değişikliklerinin saptanması amaçlanmıştır. Çalışmada Eylül 2002 ve
Kasım 2016 arasında AML tanısı alan 19-77 yaş arası geriye dönük olarak
değerlendirildi. Kemik iliği örnekleri tanı ve relaps anında elde edildi.
Hastaların 34’ü de novo, 6’sı sekonder AML idi. Kemik iliği örnekleri K3EDTA
içeren tüplere alındı. Phycoerhtyrine (PE) ve fluorescein isothiocyanate (FITC)
(eBioscience and BD Bioscience, San Jose, California) yüzey antijenleri
laboratuvarımızda kullanılan rutin panele göre kullanıldı. Analizler CD45
kapılama stratejisine göre Becton Dickinson FACSCalibur cihazı ile yapıldı.
Kırk hastanın 34’ünde (%85) en az 1 antijende değişiklik (antijen kazanımı
ve/veya kaybı) mevcuttu (n=10). Antijen değişiklikleri 2 (n=7), 3 (n=6), 4
(n=6), 5 (n=4) ya da 6 (n=1) antijende gözlendi. Antijen değişiklikleri 18
antijenin 16’sında (%88.9) saptandı. Hiçbir hastada değişiklik gözlenmeyen
antijenler sadece CD20 ve CD45’ti. AML’li hastalarda relaps sırasında
immünfenotipik kayma sıklığı yüksektir. MKH değerlendirilirken relapsta gelişen
antigen değişiklikleri göz önünde bulundurulmalıdır.

Anahtar Kelimeler

Acute myeloid leukemia, flow cytometry, relapse

Kaynakça

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