Immunological and Ultrastructural Studies in Acute Biphenotypic Leukaemia

Overview

Journal J Clin Pathol

Specialty Pathology

Date 1993 Oct 1

PMID 8227405

Citations 2

Authors

V Shetty

A Chitale

E Matutes

V Buccheri

R Morilla

D Catovsky

Affiliations

Soon will be listed here.

Abstract

Aims: To compare the sensitivity of the ultrastructural method to detect myeloperoxidase (MPO) with light microscopy and immunocytochemistry using an anti-MPO antibody; to examine the expression of lymphoid antigens in relation to MPO activity in blast cells from cases of biphenotypic leukaemia.

Methods: Blast cells from 14 cases of biphenotypic acute leukaemia were analysed. Immunological markers were performed by single or double immunofluorescence staining on a flow cytometer. The presence of MPO was determined by light microscopy, electron microscopy on fixed and unfixed cells, and by immunoalkaline phosphatase with an anti-MPO antibody. The immunogold method was applied at the ultrastructural level to assess the expression of lymphoid and myeloid antigens at the same time as the MPO activity.

Results: Six of the 14 cases were initially classified as acute lymphoblastic leukaemia (ALL) and eight as acute myeloid leukaemia (AML). MPO activity was shown at the ultrastructural level in 4-99% blasts from all cases. Six of the 14 were MPO negative by light microscopy and three of these were negative with the antibody anti-MPO. Coexpression of lymphoid antigens (CD19, CD10, or CD2) and MPO was shown by the immunogold method in four out of 11 cases; in seven cases the blasts coexpressed myeloid antigens (CD13, CD33) and MPO.

Conclusions: Electron microscopy is more sensitive for showing MPO than light microscopy and immunocytochemistry; the immunogold method combined with MPO used at the ultrastructural level can help to define the cell lineage involved in biphenotypic leukaemia by highlighting the myeloid component defined by MPO.

Citing Articles

Clinical characteristics and outcomes of mixed phenotype acute leukemia with Philadelphia chromosome positive and/or bcr-abl positive in adult.

Wang Y, Gu M, Mi Y, Qiu L, Bian S, Wang J Int J Hematol. 2011; 94(6):552-5.

PMID: 22015493 DOI: 10.1007/s12185-011-0953-1.

Clinical characteristics and outcome of children with biphenotypic acute leukemia.

Al-Seraihy A, Owaidah T, Ayas M, El-Solh H, Al-Mahr M, Al-Ahmari A Haematologica. 2009; 94(12):1682-90.

PMID: 19713227 PMC: 2791935. DOI: 10.3324/haematol.2009.009282.

References

GRAHAM Jr R, Karnovsky M . The early stages of absorption of injected horseradish peroxidase in the proximal tubules of mouse kidney: ultrastructural cytochemistry by a new technique. J Histochem Cytochem. 1966; 14(4):291-302. DOI: 10.1177/14.4.291. View

Pui C, Behm F, Kalwinsky D, MURPHY S, Butler D, Dahl G . Clinical significance of low levels of myeloperoxidase positivity in childhood acute nonlymphoblastic leukemia. Blood. 1987; 70(1):51-4. View

Bennett J, Catovsky D, Daniel M, Flandrin G, GALTON D, Gralnick H . Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group. Br J Haematol. 1976; 33(4):451-8. DOI: 10.1111/j.1365-2141.1976.tb03563.x. View

Marie J, Vernant J, Dreyfus B, BRETON-GORIUS J . Ultrastructural localization of peroxidases in 'undifferentiated' blasts during the blast crisis of chronic granulocytic leukaemia. Br J Haematol. 1979; 43(4):549-58. DOI: 10.1111/j.1365-2141.1979.tb03787.x. View

MURPHY S, Stass S, Kalwinsky D, Rivera G . Phenotypic conversion of acute leukaemia from T-lymphoblastic to myeloblastic induced by therapy with 2'-deoxycoformycin. Br J Haematol. 1983; 55(2):285-93. DOI: 10.1111/j.1365-2141.1983.tb01249.x. View

Pui C, Dahl G, Melvin S, Williams D, Peiper S, Mirro J . Acute leukaemia with mixed lymphoid and myeloid phenotype. Br J Haematol. 1984; 56(1):121-30. DOI: 10.1111/j.1365-2141.1984.tb01277.x. View

Stass S, Mirro J, Melvin S, Pui C, MURPHY S, Williams D . Lineage switch in acute leukemia. Blood. 1984; 64(3):701-6. View

BRETON-GORIUS J, Vanhaeke D, Pryzwansky K, Guichard J, Tabilio A, Vainchenker W . Simultaneous detection of membrane markers with monoclonal antibodies and peroxidatic activities in leukaemia: ultrastructural analysis using a new method of fixation preserving the platelet peroxidase. Br J Haematol. 1984; 58(3):447-58. DOI: 10.1111/j.1365-2141.1984.tb03991.x. View

NEAME P, Soamboonsrup P, Browman G, Barr R, Saeed N, Chan B . Simultaneous or sequential expression of lymphoid and myeloid phenotypes in acute leukemia. Blood. 1985; 65(1):142-8. View

10.

Polli N, OBrien M, Tavares de Castro J, Matutes E, San Miguel J, Catovsky D . Characterization of blast cells in chronic granulocytic leukaemia in transformation, acute myelofibrosis and undifferentiated leukaemia. I. Ultrastructural morphology and cytochemistry. Br J Haematol. 1985; 59(2):277-96. DOI: 10.1111/j.1365-2141.1985.tb02994.x. View

11.

Vainchenker W, Villeval J, Tabilio A, Matamis H, Karianakis G, Guichard J . Immunophenotype of leukemic blasts with small peroxidase-positive granules detected by electron microscopy. Leukemia. 1988; 2(5):274-81. View

12.

Matutes E, Pombo de Oliveira M, Foroni L, Morilla R, Catovsky D . The role of ultrastructural cytochemistry and monoclonal antibodies in clarifying the nature of undifferentiated cells in acute leukaemia. Br J Haematol. 1988; 69(2):205-11. DOI: 10.1111/j.1365-2141.1988.tb07623.x. View

13.

Cross A, Goorha R, Nuss R, Behm F, MURPHY S, Kalwinsky D . Acute myeloid leukemia with T-lymphoid features: a distinct biologic and clinical entity. Blood. 1988; 72(2):579-87. View

14.

Lavabre-Bertrand T, Vannereau H, Donadio D, Escola M, Taib J, Poncelet P . Interest of simultaneous ultrastructural characterization of morphology, cytochemistry and immune phenotype in a case of putative hybrid acute leukaemia. Eur J Haematol. 1989; 42(2):202-6. DOI: 10.1111/j.1600-0609.1989.tb01211.x. View

15.

Polli N, Lambertenghi-Deliliers G, Schiro R, Cattoretti G, Soligo D, Cantu-Rajnoldi A . Relevance of ultrastructural immunocytochemistry in the characterization of unclassifiable leukemias: correlation with phenotypic and genic studies. Haematologica. 1989; 74(2):129-36. View

16.

Akashi K, Shibuya T, Harada M, Morioka E, Oshima K, Kimura N . Acute 'bilineal-biphenotypic' leukaemia. Br J Haematol. 1990; 74(4):402-7. DOI: 10.1111/j.1365-2141.1990.tb06326.x. View

17.

Kantarjian H, Yee G, Huh Y, Freireich E, Stass S . Mixed-lineage leukemia revisited: acute lymphocytic leukemia with myeloperoxidase-positive blasts by electron microscopy. Blood. 1990; 76(4):808-13. View

18.

Campana D, Hansen-Hagge T, Matutes E, Coustan-Smith E, Yokota S, Shetty V . Phenotypic, genotypic, cytochemical, and ultrastructural characterization of acute undifferentiated leukemia. Leukemia. 1990; 4(9):620-4. View

19.

Guyotat D, Campos L, Shi Z, Charrin C, Treille D, Magaud J . Myeloid surface antigen expression in adult acute lymphoblastic leukemia. Leukemia. 1990; 4(9):664-6. View

20.

Heil G, Gunsilius E, Raghavachar A, Bartram C, Ganser A, Kurrle E . Ultrastructural demonstration of peroxidase expression in acute unclassified leukemias: correlation to immunophenotype and treatment outcome. Blood. 1991; 77(6):1305-12. View