Immunophenotyping Results from Flow Cytometric Analysis of Children with Acute Leukemia in Ahwaz Province

Abstract

Introduction: Acute leukemia is the most common malignancy in children and acute lymphoblastic leukemia (ALL) accounts for 75% of acute leukemia cases. New treatment protocols have resulted in complete remission rates up to nearly 100% in children with acute lymphoblastic leukemia. Today, one of the most important prognostic factors in acute lymphoblastic leukemia is intensity of the treatment. Risk stratification is accomplished based on clinical, morphological, immune-phenotypic and cytogenetic findings. The aim of this study was to determine some prognostic factors in children with acute lymphoblastic leukemia.Methods: In this retrospective study information about age at onset of acute leukemia, sex, initial white blood cell count, FAB-subtype, immunophenotype, and clinical course of newly diagnosed acute lymphoblastic leukemia were extracted from medical records of children admitted to pediatric oncology department of Shafa Hospital between 2011 and 2012.Results: There were 21 male patients (51.2%) and 20 were female patients (48.8%). The mean age was 4.2 ± 6.34 years, and 24 patients (58.5%) had Arab origins, while 17 patients (41.5%) were of non-Arab ethnicity. Age distribution showed higher incidence of ALL in younger children: 1-4 years 47.5%, 5-9 years 27.5% and 25% in patients >10 years.L2 subtype was more common in our patients 51.2% while L1 subtype was reported 46.3%.Only one patient was reported to be L3 subtype (2.4%), yet we did not detect any significant relation between different age groups and trend for incidence for specific subtype. The number of white blood cell (WBC) at the time of admission was reported as: less than 10,000 cells/cm in 30%, between11-50,000 in 37.5% and >50,000 in 32.5% patients .Organ involvement was present in 47.5%, and central nervous involvement, ( proved by positive malignant cells in CSF fluid) was detected in 4.9% of our patients. In our study, HLA-DR was 62.5 % in ALL patients and CD 20 and CD19 was the most common marker in these patients. In our work the most common markers in L1, which was found in 19 patients were reported CD 19, CD33, CD22, CD35, CD20 and CD9. Also the percentage of markers in L2 subtype had a similarity to L1 group.Conclusions: Conclusion: In this study, FAB-subtype L1 was less than previous studies, while FAB-subtype L2 and pre-B cell immunophenotype was more common than previous studies. Other results were the same as reported in older studies.