Study of Acute Leukemia Pattern by Flow Cytometric Analysis: An Experience from Eastern India

Introduction These lymphocytes (acute lymphocytic leukemia [ALL]) or myeloid cells (acute myelocytic leukemia [AML]) proliferate abnormally. Leukemia is the most common cancer among children, with ALL accounting for 78% of all childhood leukemia's. The most common type of leukemia in adults is AML, followed by CLL, CML & ALL (Clonal disease). Acute lymphoblastic leukemia (ALL) may be distinguished from other malignant lymphoid disorders by the immunophenotype of the cells, which is similar to B or T precursor cells. Objective The main purpose of our study is to detect the characteristics of immunophenotypes of ALL patients in Eastern India and to analyze the frequency of typical immunophenotypes responsible for ALL. The study also investigates the nature of blast cell population in samples of bone marrow as well as peripheral blood of patients, explores the case history and correlates the immunophenotyping data with clinical treatment for better diagnostic approach. Materials and methods 96 pediatric leukemia patients of 1 to 17 years of age (median 9 years) were studied during a period from January, 2009 to December, 2010. Cells were analyzed with four-colour flow cytometry. Non lineage specific markers used were CD34, HLA-DR, CD117; B-lineage specific markers were CD19, CD22, CD10 and T-lineage specific markers were CD5, CD7, CD2, CD3, CD4, CD33. Immunophenotypes were compared at diagnosis. Results The data showing average % of specific positive markers were tabulated below. Positive markers Total (%) CD19 95.23 (Male 71.24, Female 23.08) CD22 80.95 (Male 61.90, Female 19.04) CD10 66.66 (Male 52.38, Female 19.04) CD34 38.09 (Male 23.80, Female 14.28) HLA-DR 23.80 CD2 9.52 CD7 19.04 (Male 14.28) Other markers present were CD33, CD13, CD117, CD3 and CD4, at an average of 4.76%. Conclusion Pattern of ALL follows B-cell-lineage origin with mostly pre B-cell and CD19 positive cases in Eastern India. This is the first reported data from Eastern India which is showing the prevalence of B-ALL as Northern and Western India; whereas the southern part of India reveals the prevalence of T-ALL Disclosure All authors have declared no conflicts of interest.