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VOLUME 50 , ISSUE 4 ( October-December, 2016 ) > List of Articles

RESEARCH ARTICLE

Immunophenotyping in Chronic Myeloid Leukemia Blast Crisis: Looking beyond Morphology

Subhash Varma, Neelam Varma, Pankaj Malhotra, Vikram Narang, Man US Sachdeva, Parveen Bose

Citation Information : Varma S, Varma N, Malhotra P, Narang V, Sachdeva MU, Bose P. Immunophenotyping in Chronic Myeloid Leukemia Blast Crisis: Looking beyond Morphology. J Postgrad Med Edu Res 2016; 50 (4):181-184.

DOI: 10.5005/jp-journals-10028-1215

Published Online: 00-12-2016

Copyright Statement:  Copyright © 2016; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

Patients of chronic myeloid leukemia (CML) eventually transform to blast crisis (BC) after a variable length of chronic phase (CP). With improvement in management protocols, many patients of CML-BC are expected to show remission after initial chemotherapy and a better survival. Hence, it becomes imperative to correctly classify the nature of BC for further course of management.

Materials and methods

This study retrospectively analyzed cases of CML-BC, over a period of 5 years, with comprehensive immunophenotyping done on flow cytometry.

Results

Fifteen cases of CML-BC with male-to-female ratio of 3:1 and mean age of 40.2 years were included in the study. Flow cytometry revealed 14 cases of myeloid and one case of lymphoid BC. One case each of megakaryocytic and myelomonocytic lineage were seen among the 14 cases of myeloid BC. Aberrant marker expression was a common occurrence. Myeloperoxidase cytochemical stain had shown positivity only in 3 of the 14 cases of myeloid BC.

Conclusion

Immunophenotyping is necessary for assigning specific lineage to blasts in patients of CML-BC and thus providing clinically useful information regarding the treatment protocols and prognosis of the patient.

How to cite this article

Narang V, Sachdeva MUS, Bose P, Varma N, Malhotra P, Varma S. Immunophenotyping in Chronic Myeloid Leukemia Blast Crisis: Looking beyond Morphology. J Postgrad Med Edu Res 2016;50(4):181-184


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  1. Factors affecting duration of survival after onset of blastic transformation of chronic myeloid leukemia. Blood 2002 Apr 1;99(7): 2304-2309.
  2. Differentiation patterns in the blastic phase of chronic myeloid leukemia. Blood 1983 Jan;61(1):85-91.
  3. Role of immunophenotyping in characterisation of blast crisis of chronic myeloid leukemia – a study of 25 cases. Indian J Pathol Microbiol 1996 Jan;39(1):13-17.
  4. Immunophenotype of blast crisis in chronic myeloid leukemia. Schweiz Med Wochenschr 1998 Oct 17;128(42):1624-1626.
  5. ‘Lymphoid’ blast crisis of chronic myeloid leukaemia is associated with distinct clinicohaematological features. Br J Haematol 1998 Jan;100(1):123-128.
  6. The morphological, immunophenotypical and cytogenetic characteristics study of blast crisis in chronic myeloid leukemia. Zhonghua Nei Ke Za Zhi 2002 Oct;41(10):685-687.
  7. Characterisation of blast cells during blastic phase of chronic myeloid leukaemia by immunophenotyping – experience in 60 patients. Leuk Res 1988;12(6):499-506.
  8. Cell lineage heterogeneity in blast crisis of chronic myeloid leukaemia. Br J Haematol 1985 Mar;59(3):395-409.
  9. The preferential expression of CD7 and CD34 in myeloid blast crisis in chronic myeloid leukemia. Blood 2000 Mar 15;95(6):2188-2189.
  10. Flow cytometric diagnosis of myelodysplasia and myeloproliferative disorders. J Biol Regul Homeost Agents 2004 Apr-Jun;18(2):141-145.
  11. Phenotypic changes in a case of blast crisis of CML: characterization by TdT, cytochemistry, and cytogenetics. Scand J Haematol 1981 Oct;27(4):241-246.
  12. Chronic myelogenous leukemia in blast crisis. Analysis of 242 patients. Am J Med 1987 Sep;83(3):445-454.
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