Flow cytometric analysis of CD64 expression pattern and density in the diagnosis of acute promyelocytic leukemia: a multi-center study in Shanghai, China
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Min Liu1,*, Xiangqin Weng2,*, Shenglan Gong1, Hui Chen1, Jing Ding1, Mengqiao Guo1, Xiaoxia Hu1, Jianmin Wang1, Jianmin Yang1 and Gusheng Tang1
1Department of Hematology, Changhai Hospital, The Second Military Medical University, Shanghai, China
2Institute of Hematology, Ruijin Hospital, Jiaotong University, Shanghai, China
*These authors contributed equally to this work
Gusheng Tang, email: firstname.lastname@example.org
Jianmin Yang, email: email@example.com
Keywords: acute promyelocytic leukemia (APL), APL diagnostic immunophenotypic panel, flow cytometry, diagnostic performance
Received: June 26, 2017 Accepted: August 23, 2017 Published: September 11, 2017
No unified immunophenotypic profiles and corresponding analytic strategies have been established for the rapid diagnosis of acute promyelocytic leukemia (APL) using flow cytometry (FCM). Here we describe a characteristic immunophenotypic panel that can rapidly and accurately distinguish APL from other types of adult acute myeloid leukemia (AML) using only FCM. By comparing APL cells and non-APL AML cells that share APL common immunophenotypes (CD34−CD117+HLA−DR−) we found that CD64 was a significant factor that differentiated APL from other AMLs. Further retrospective analyses of 205 APL and 629 non-APL AML patients from different hematology centers showed that either the CD64dim and homoCD13+homo CD33+homoMPO+ (myeloperoxidase) CD11c− panel or the CD64dim and homoCD13+homo CD33+homoMPO+ CD11c+CD10−CD117+ SSChigh (high side scatter signal) panel could distinguish APL from non-APL AML patients with nearly 100% sensitivity, specificity and accuracy. Moreover, relative quantification of CD64 expression enhanced the applicability of our APL diagnostic immunophenotypic panels (ADI-panels) in different hematology centers. Application of the ADI-panels will decrease diagnosis time and improve personalized treatment for APL, a life-threatening disease with very rapid progression.
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