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The Immunophenotype of 325 Adult Acute Leukemias
Relationship to Morphologic and Molecular Classification and Proposal for a Minimal Screening Program Highly Predictive for Lineage Discrimination

Renate Thalhammer-Scherrer MD, Gerlinde Mitterbauer MD, Ingrid Simonitsch MD, Ulrich Jaeger MD, Klaus Lechner MD, Barbara Schneider PhD, Christa Fonatsch MD, Ilse Schwarzinger MD
DOI: http://dx.doi.org/10.1309/C38D-D8J3-JU3E-V6EE 380-389 First published online: 1 March 2002


Bone marrow cells of 325 adults with acute leukemia were immunophenotyped using a panel of monoclonal antibodies proposed by the European Group for the Immunological Characterization of Leukemias (EGIL). Of these, 97.2% could be assigned clearly to myeloid or lymphoid lineage (254 acute myeloid leukemias [AMLs], 48 B-cell lineage acute lymphoblastic leukemias [ALLs], 14 T-cell lineage ALLs), 1.8% as biphenotypic, and less than 1% as undifferentiated. Immunologic subtyping of ALLs revealed an association between early precursor phenotypes and coexpression of myeloid antigens, particularly CD15/CD65s coexpression and pre-pre-B cell–specific phenotypes and genotypes. The common ALL phenotype was associated with BCR-ABL translocation. Among AMLs, CD2 coexpression was almost exclusively restricted to French-American-British subtypes M3 variant and M4Eo and related molecular aberrations. The most valuable markers to differentiate between myeloperoxidase-negative AML subtypes M0 and ALLs were CD13, CD33, and CD117, typical of M0, and intracytoplasmic CD79a, intracytoplasmic CD3, CD10, and CD2, typical of B cell– or T cell–lineage ALL. Our results confirm excellent practicability of the EGIL proposal for immunologic classification of acute leukemias. For myeloperoxidase-negative AMLs, we suggest a scoring system based on markers most valuable to distinguish between AML-M0 and ALLs.

Key Words:
  • Adult acute leukemia
  • Immunophenotype
  • Classification
  • AML-M0
  • Acute lymphoblastic leukemia
  • ALL
  • Scoring system