Acute lymphoblastic leukemia other diagnostic studies: Difference between revisions
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==Flow cytometry== | ==Flow cytometry== | ||
[[Flow cytometry]] should be performed to characterize expression of lineage-defining antigens and allow determination of the specific acute lymphoblastic leukemia subtype.<ref name=ALL>{{cite web | title = National Cancer Institute| url =http://www.cancer.gov/types/leukemia/hp/adult-all-treatment-pdq#link/_44_toc }}</ref> | *[[Flow cytometry]] should be performed to characterize expression of lineage-defining antigens and allow determination of the specific acute lymphoblastic leukemia subtype.<ref | ||
*The following markers are seen on flow cytometry, but there are also used for differentiating from other abnormalities of bone marrow cells:name=ALL>{{cite web | title = National Cancer Institute| url =http://www.cancer.gov/types/leukemia/hp/adult-all-treatment-pdq#link/_44_toc }}</ref><ref name="pmid25408859">{{cite journal| author=Chiaretti S, Zini G, Bassan R| title=Diagnosis and subclassification of acute lymphoblastic leukemia. | journal=Mediterr J Hematol Infect Dis | year= 2014 | volume= 6 | issue= 1 | pages= e2014073 | pmid=25408859 | doi=10.4084/MJHID.2014.073 | pmc=4235437 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25408859 }} </ref> | |||
**CD19 | |||
**CD20 | |||
**CD22 | |||
**CD24, | |||
**CD79a | |||
==RT-PCR and FISH== | ==RT-PCR and FISH== |
Revision as of 21:24, 1 February 2019
Acute lymphoblastic leukemia Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Carlos A Lopez, M.D. [3]
Overview
Other diagnostic studies for acute lymphoblastic leukemia include cytogenetics, bone marrow biopsy, flow cytometry, RT-PCR and FISH.
Cytogenetics
- In Cytogenetics the following establishes whether the "blast" cells began from the B lymphocytes or T lymphocytes
- DNA testing can establish how aggressive the disease is; different mutations have been associated with shorter or longer survival.
Biopsy
- A biopsy is the only sure way to know whether leukemia cells are in the bone marrow
- Before the sample is taken, local anesthesia is used to numb the area. This helps reduce the pain.
- Bone marrow from your hipbone or another large bone is taken as biopsy.[1]
- On biopsy the following is seen:[2]
- High number of lymphoblast
- Hypercellular marrow with subtotal depletion of fat cells[2]
- Normal blood cell precursors
- A bone marrow biopsy and aspirate are routinely performed even in T-cell acute lymphoblastic leukemia to determine the extent of marrow involvement
- Malignant cells should be sent for conventional cytogenetic studies, as detection of the Ph1 t(9;22), myc gene rearrangements (in Burkitt leukemia), and MLL gene rearrangements add important prognostic information[3]
Flow cytometry
- Flow cytometry should be performed to characterize expression of lineage-defining antigens and allow determination of the specific acute lymphoblastic leukemia subtype.[4]
- CD19
- CD20
- CD22
- CD24,
- CD79a
RT-PCR and FISH
- In addition, for B-cell disease the malignant cells should be analyzed using RT-PCR and FISH for evidence of the bcr-abl fusion gene. This last point is of utmost importance, as timely diagnosis of Ph1 acute lymphoblastic leukemia will significantly change the therapeutic approach.[3]
References
- ↑ Harrison's Principles of Internal Medicine, 16th EditioN, Chapter 97. Malignancies of Lymphoid Cells. Clinical Features, Treatment, and Prognosis of Specific Lymphoid Malignancies.
- ↑ 2.0 2.1 Kröber SM, Greschniok A, Kaiserling E, Horny HP (2000). "Acute lymphoblastic leukaemia: correlation between morphological/immunohistochemical and molecular biological findings in bone marrow biopsy specimens". Mol Pathol. 53 (2): 83–7. PMC 1186910. PMID 10889907.
- ↑ 3.0 3.1 "National Cancer Institute".
- ↑ Chiaretti S, Zini G, Bassan R (2014). "Diagnosis and subclassification of acute lymphoblastic leukemia". Mediterr J Hematol Infect Dis. 6 (1): e2014073. doi:10.4084/MJHID.2014.073. PMC 4235437. PMID 25408859.