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Immunohistochemistry Can Be Used to Subtype Acute Myeloid Leukemia in Routinely Processed Bone Marrow Biopsy Specimens
Comparison With Flow Cytometry

Elizabeth J. Manaloor MD, Richard S. Neiman MD, Douglas K. Heilman MS, Maher Albitar MD, Thomas Casey MD, Tanya Vattuone MD, Patricia Kotylo MD, Attilio Orazi MD
DOI: http://dx.doi.org/10.1309/NALM-440G-4GFY-XPVE 814-822 First published online: 1 June 2000


Flow cytometry (FC) is the preferred method of immunophenotyping acute myeloid leukemia (AML). However, there are situations in which FC is unavailable and in which immunohistologic staining of bone marrow biopsy specimens can be used to provide immunophenotypic information. To evaluate immunohistologic staining and to confirm its value, we selected 80 newly diagnosed cases of AML that were classified according to French-American-British (FAB) criteria and confirmed by flow cytometric analysis for this study. Paraffin-embedded bone marrow specimens were stained using a panel of antibodies that included CD34 (QBEND10), antimyeloperoxidase (anti-MPO), antihemoglobin, factor VIII–related antigen, and 3 epitopes of CD 68 (HAM56, KP1, and PG-M1). Our findings suggest that with the use of the paraffinreactive antibodies CD34 (QBEND10), MPO, CD68 (PG-M1), antihemoglobin, and factor VIII–related antigen, immunohistochemistry can be used to subclassify AML. Comparison of immunohistochemical results with FC immunophenotyping suggests that there is significant concordance in the results for markers that can be used with both techniques, indicating that the sensitivity and specificity of both methods is comparable (P> .53 in all cases).

Key Words:
  • Acute myeloid leukemia
  • Immunohistology
  • Flow cytometry
  • French-American-British Cooperative Group Classification