Utility of CD2 expression in acute promyelocytic leukemia microgranular phenotype and acute myeloid leukemia with <i>CBFB-MYH11</i>

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  • TAKAYA Emiri
    Department of Central Clinical Laboratory, Hakodate Municipal Hospital
  • SAITO Yasutomo
    Department of Central Clinical Laboratory, Hakodate Municipal Hospital
  • OGASAWARA Manami
    Department of Central Clinical Laboratory, Hakodate Municipal Hospital
  • NAKAGAWA Chisato
    Department of Central Clinical Laboratory, Hakodate Municipal Hospital
  • SAKUTA Yasuhiro
    Department of Central Clinical Laboratory, Hakodate Municipal Hospital
  • TAKABUCHI Yutaro
    Department of Central Clinical Laboratory, Hakodate Municipal Hospital
  • KIKUCHI Nao
    Department of Central Clinical Laboratory, Hakodate Municipal Hospital
  • AKITA Ryuji
    Department of Central Clinical Laboratory, Hakodate Municipal Hospital

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Other Title
  • <i>PML-RARA</i>を伴う急性前骨髄球性白血病（microgranular type）および<i>CBFB-MYH11</i>を伴う急性骨髄性白血病におけるCD2抗原の有用性
  • PML-RARAを伴う急性前骨髄球性白血病(microgranular type)およびCBFB-MYH11を伴う急性骨髄性白血病におけるCD2抗原の有用性
  • PML-RARA オ トモナウ キュウセイ ゼン コツズイキュウセイ ハッケツビョウ(microgranular type)オヨビ CBFB-MYH11 オ トモナウ キュウセイ コツズイセイ ハッケツビョウ ニ オケル CD2 コウゲン ノ ユウヨウセイ

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Abstract

<p>Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia characterized by abnormal proliferation of promyelocytes and PML-RARA fusion gene. The microgranular type of APL (M3v) is characterized by a lack of cytoplasmic granules and atypical of nuclei. Thus, it is important to differentiate it from other types of monocytic AML on the basis of morphological features. Moreover, AML with CBFB-MYH11, known as M4Eo in the French–American–British classification, is diagnosed by the proliferation of myeloblasts, monoblasts, and abnormal bone-marrow eosinophils. To determine whether the CD2 expression is useful for the early detection of M3v and M4Eo, we investigated immunophenotypes especially focusing on CD2, morphologic features, and genetic/chromosomal abnormalities of APL including M3v, M4, and M4Eo. In an immunophenotypic analysis by flow cytometry (FCM), all cases of APL without the variant type were negative for CD2, and only one case of M4 showed CD2 expression. However, four of five cases (80%) of the M3v type were positive for CD2. Furthermore, eight of ten cases (75%) of M4Eo were positive for CD2. In comparison with other types of AML, including M0–M5, the frequencies of CD2 expression in M3v and M4Eo cases were statistically significantly higher (p < 0.001). In genetic and chromosomal investigations, PML-RARA mRNA and t(15;17) were detected in all cases of M3 and M3v. Moreover, all 10 cases of M4Eo showed CBFB-MYH11 mRNA, and inv(16). From these findings, the CD2 antigen will be a useful marker for diagnosing two types of leukemia, M3v and M4Eo, in the early stages, even though it is difficult to determine the type of disease on the basis of morphological findings.</p>

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