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DOI: 10.4103/ijmpo.ijmpo_216_19
Utility of Immunohistochemistry on Bone Marrow Trephine Biopsy for the Diagnosis and Classification of Acute Leukemia
Financial support and sponsorship Nil.
Abstract
Background: Bone marrow examination is an essential diagnostic tool in acute leukemia for the determination of lineage of blasts by flow cytometry or immunophenotyping. In cases of dry tap or where facilities of flow cytometry is not available, immunohistochemistry (IHC) on trephine biopsy sections can be used as a supportive tool to diagnose and classify acute leukemia. Materials and Methods: The giemsa-stained peripheral smears and bone marrow aspirate/imprints smears were retrospectively evaluated. IHC was done on trephine biopsy sections using a panel of antibodies which included CD34, MPO, CD117, Tdt, CD3, CD20, PAX5, and CD10 Results: Of the 29 cases diagnosed by IHC on trephine sections, 25 cases could be accurately classified based on the expression of myeloid and lymphoid markers. Majority of the acute lymphoblastic leukemia (ALL) were of B-cell lineage (81.25%), and almost half of the B-ALL were common acute lymphoblastic leukemia-associated antigen positive. Conclusion: IHC on trephine biopsy facilitates the confirmation and subtyping of leukemia in more than 85% cases. A limited panel of antibodies using CD34, MPO, TdT, CD3 CD20, PAX 5, and CD10 can be used for subtyping of leukemias in trephine biopsy sections, especially in centers with limited resources. It obviates the need for a repeat bone marrow procedure where material is not available for flow cytometry.
Publication History
Received: 23 October 2019
Accepted: 01 June 2019
Article published online:
17 May 2021
© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)
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References
- 1 Arber DA, Brunning RD, Le Beau MM, Falini B, Vardiman JW, Porwit A. et al. Acute myeloid leukemia with recurrent genetic abnormalities. In: Swerdlow SH, Campo E, Harris NL, Jafee ES, Pileri SA, Stein H. editors WHO Classification of Tumors of Haematopoietic and Lymphoid Tissues. Revised 4th ed. France: International Agency for Research on Cancer; 2017: 129-30
- 2 Al Gwaiz LA, Bassioni W. Immunophenotyping of acute lymphoblastic leukemia using immunohistochemistry in bone marrow biopsy specimens. Histol Histopathol 2008; 23: 1223-8
- 3 Kroft SH. Role of flow cytometry in pediatric hematopathology. Am J Clin Pathol 2004; 122 Suppl: S19-32
- 4 Dunphy CH. Gene expression profiling data in lymphoma and leukemia: Review of the literature and extrapolation of pertinent clinical applications. Arch Pathol Lab Med 2006; 130: 483-520
- 5 Arber DA, Jenkins KA. Paraffin section immunophenotyping of acute leukemias in bone marrow specimens. Am J Clin Pathol 1996; 106: 462-8
- 6 Herman GE, Elfont EA, Floyd AD. Overview of automated immunostainers. Methods Mol Biol 1994; 34: 383-403
- 7 Cuevas EC, Bateman AC, Wilkins BS, Johnson PA, Williams JH, Lee AH. et al. Microwave antigen retrieval in immunocytochemistry: A study of 80 antibodies. J Clin Pathol 1994; 47: 448-52
- 8 Blumenthal D, Gluck M, Louis KS, Stoto MA, Wise D. University-industry research relationships in biotechnology: Implications for the university. Science 1986; 232: 1361-6
- 9 Olsen RJ, Chang CC, Herrick JL, Zu Y, Ehsan A. Acute leukemia immunohistochemistry: A systematic diagnostic approach. Arch Pathol Lab Med 2008; 132: 462-75
- 10 Orazi A, Cotton J, Cattoretti G, Kotylo PK, John K, Manning JT. et al. Terminal deoxynucleotidyl transferase staining in acute leukemia and normal bone marrow in routinely processed paraffin sections. Am J Clin Pathol 1994; 102: 640-5
- 11 Chu PG, Loera S, Huang Q, Weiss LM. Lineage determination of CD20- B-Cell neoplasms: An immunohistochemical study. Am J Clin Pathol 2006; 126: 534-44
- 12 Gibson SE, Dong HY, Advani AS, Hsi ED. Expression of the B cell-associated transcription factors PAX5, OCT-2, and BOB.1 in acute myeloid leukemia: Associations with B-cell antigen expression and myelomonocytic maturation. Am J Clin Pathol 2006; 126: 916-24
- 13 Chuang SS, Li CY. Useful panel of antibodies for the classification of acute leukemia by immunohistochemical methods in bone marrow trephine biopsy specimens. Am J Clin Pathol 1997; 107: 410-8
- 14 Bain BJ. Leukemia Diagnosis. 4th ed. Singapore: Wiley-Blackwell; 2010: 64-113
- 15 Subashchandrabose P, Ramiah Madanagopaal L, Subba Rao TM. Diagnosis and classification of acute leukemia in bone marrow trephine biopsies, utility of a selected panel of minimal immunohistochemical markers. Int J Hematol Oncol Stem Cell Res 2016; 10: 138-46