CD 117: Lineage assigning marker in acute myeloid leukemias

Authors

  • Shuaeb Bhat Department of Pathology, Government Medical College, Anantnag, Jammu and Kashmir, India
  • Fatima Rahim Department of Hematopathology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
  • Sajad Geelani Department of Clinical Hematology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
  • Saleem Hussain Department of Hematopathology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
  • Syed Mudasir Qadri Department of Internal Medicine, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20191145

Keywords:

Acute myeloid leukemia, CD117, Immunophenotyping, Myeloblasts

Abstract

Background: Acute Myeloid Leukemia (AML) is a malignancy of the cells of myeloid series characterized by the rapid growth of Myeloblasts. The diagnosis of AML is established by demonstration of more than 20% of the blood and/or bone marrow by leukemic myeloblasts. Immunophenotyping is one of the most useful tool for the confirmation, lineage assignment and subtyping of leukemias. This study was aimed to phenotype and classify acute leukemias by flow cytometry using commonly used markers for leukemia diagnosis and to establish whether CD 117 can be considered as a lineage specific marker in diagnosis and subclassification of AML.

Methods: Flow Cytometric Immunophenotyping was employed for the study. The myeloid antibodies employed in AML in our study included - CD117, CD11c, CD13, CD15, CD33, CD34, CD36, CD41, CD65 and MPO.

Results: In our study AMLs constituted 46% of all acute leukemias. CD117 positivity was seen in 86.56% of the French American British (FAB) category of AML. The blasts gated using CD45 v/s SSC revealed variable expression of CD34, CD13 and CD33. The expression of CD117 was consistent particularly in AML-M0, AML-M1 and AML M2.

Conclusions: CD117 is virtually a myeloid blast marker with a high sensitivity, specificity and positive predictive value. Among the various myeloid markers like cMPO, CD13, CD33 and CD117, it is just CD117 that has got a tremendous reproducibility in AMLs. Besides CD117 is a surface marker unlike MPO thus easier to process, time saving and less prone to nonspecific binding.

References

Huang ME, Ye YC, Chen SR, Chai JR, Lu JX, Zhoa L, et al. Use of all-trans retinoic acid in the treatment of acute promyelocytic leukemia. Blood. 1988 Aug 1;72(2):567-72.

Cancer Genome Atlas Research Network . Genomic and epigenomic landscapes of adult de novo acute myeloid leukemia. N Engl J Med. 2013;368:2059-74.

Mrozek K, Marcucci G, Paschka P, Whitman SP, Bloomfield CD. Clinical relevance of mutations and gene-expression changes in adult acute myeloid leukemia with normal cytogenetics: are we ready for a prognostically prioritized molecular classification? Blood. 2007;109:431-48.

Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J et al. The World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues. Report of the Clinical Advisory Committee meeting, Airlie House, Virginia, November, 1997. J Clin Oncol. 1999;17:3835-49.

Kathryn Foucar, John Anastasi. Acute Myeloid Leukemia with Recurrent Cytogenetic Abnormalities. Am J Clin Pathol. 2015;144:6-18.

Ashkan Emadi, Maria R. Baer. Acute Myeloid Leukemia in Adults. Wintrobe’s Clinical Hematology, 13th ed. Lippincott Williams & Wilkins, 2014:1577.

Bene MC. Immunophenotyping of acute leukaemias. Immunol Lett. 2005 Apr 15;98(1):9-21.

Casasnovas RO, Slimane FK, Garand R, Faure GC, Campos L, Deneys V, et al. Immunological classification of acute myeloblastic leukemias: relevance to patient outcome. Leukemia. 2003 Mar;17(3):515.

Kaleem Z, Crawford E, Pathan MH, Jasper L, Covinsky MA, Johnson LR, et al. Flow cytometric analysis of acute leukemias. Diagnostic utility and critical analysis of data. Arch Pathol Lab Med. 2003;127:42-8.

Jennings CD and Foon KA. Recent advances in flow cytometry: application to the diagnosis of hematologic malignancy. Blood. 1997;90:2863-92.

Hans CP, Finn WG, Singleton TP, Schnitzer B, Ross CW. Usefulness of anti-CD117 in the flow cytometric analysis of acute leukemia. Am J Clin Pathol. 2002 Feb 1;117(2):301-5.

Osman IM, Humeida AA, Eltayeb O, Abdelrhman I, Elhadi TA. Flowcytometric Immunophenotypic characterization of acute myeloid leukemia (AML) in Sudan. Int J Hematol Disor. 2015 Jan 23;2(1):10-7.

Saxena R, Anand H. Flow cytometry in acute leukemia. Indian J Hematol Blood Transfus. 2008 Dec; 24(4): 146–150.

Hans CP, Finn WG, Singleton TP, Schnitzer B, Ross CW. Usefulness of anti-CD117 in the flow cytometric analysis of acute leukemia. Am J Clin Pathol. 2002 Feb 1;117(2):301-5.

Nomdedéu JF, Mateu R, Altès A, Llorente A, Rio C, Estivill C, et al. Enhanced myeloid specificity of CD 117 compared with CD13 and CD33. Leukemia Re. 1999 Apr 1;23(4):341-7.

Wells SJ, Bray RA, Stempora LL, Farhi DC. CD117/CD34 expression in leukemic blasts. Am J Clin Pathol. 1996;106:192-5.

Auewarakul CU, Lauhakirti D, Promsuwicha O, Munkhetvit C. C-kit receptor tyrosine kinase (CD117) expression and its positive predictive value for the diagnosis of Thai adult acute myeloid leukemia. Ann Hematol. 2006 Feb 1;85(2):108-12.

Pomerantz A, Rodríguez-Rodríguez S, Demichelis-Gómez R, Barrera-Lumbreras G, Barrales-Benítez OV, Díaz-Huízar MJ, et al. Importance of CD117 in the Assignation of a Myeloid Lineage in Acute Leukemias. Arch Med Res. 2017 Feb 1;48(2):212-5.

Ahmadi A, Poorfathollah AA, Aghaiipour M, Rezaei M, Nikoo-ghoftar M, Abdi M, et al. Diagnostic value of CD117 in differential diagnosis of acute leukemias. Tumor Biol. 2014 Jul 1;35(7):6763-8.

Chirayu U. Auewaraku Darat Lauhakirti, Orathai Promsuwicha, Chanya Munkhetvit. et al. C-kit receptor tyrosine kinase (CD117) expression and its positive predictive value for the diagnosis of Thai adult acute myeloid leukemia. Ann Hematol. 2006 Feb:85(2):108-12.

Béné MC, Bernier M, Casasnovas RO, Castoldi G, Knapp W, Lanza F, et al. The reliability and specificity of c-kit for the diagnosis of acute myeloid leukemias and undifferentiated leukemias. Blood. 1998 Jul 15;92(2):596-9.

Newell JO, Cessna MH, Greenwood J, Hartung L, Bahler DW. Importance of CD117 in the evaluation of acute leukemias by flow cytometry. Cytometry Part B: Clin Cytometry. 2003 Mar 1;52(1):40-3.

Downloads

Published

2019-03-25

Issue

Section

Original Research Articles