A reference that comes to mind:
Hanson et al Lab Invest 66:78A, 1992
In this study- 12 out of 210 acute leukemias were CD45 negative. Of
the CD45 negative B-precursor ALL's - 1 had a t(9;220 and 2 had t(4;11).
I wouldn't call this one biphenotypic. There is no myeloperoxidase
positivity, correct? It could be an ALL with aberrant expression of myeloid
antigens.
Thank you for sharing this interesting case.
Maryalice
>Dear list members
>
>Have you ever seen a case of CD45 (leukocyte common antigen)-negative
>acute leukemia?
>
>The male patient was in his early 30's and visited our hospital with
>chief complaint of low platelet number. He felt fatigue and experienced
>easy bruisability but looked well.
>At the time of visit on Jan 6, 1998, the CBC data was WBC 6,000/uL,
>Hb 8.5 g/dL, platelet 24K/uL. The peripheral blood smear showed
>30% leukemic blasts and bone marrow revealed 89.6% medium sized leukemic
>blasts with high N/C ratio, fine chromatin, and absent to one nucleolus.
>
>Cytochemical stain was done; peroxidase (-), SBB (-), PAS (pinkish background
>staining), Non-specific esterase (-).
>
>Flow cytometric analysis of bone marrow aspirates revealed a predominant
>population of cells with a lymphoid light scatter. These leukemic blasts
>has following immunophenotype;
>
> CD34 (+; 94%), HLA-DR (+; 96%), nuclear TdT (+; 92%)
> CD33 (+; 53%), CD13 (+; 88%), CD61 (-)
> CD7 (-), CD5 (-), CD2 (-)
> CD20 (+; 27%), CD1
>9 (+; 90%), kappa (-), lambda (-), CD10 (+; 90%)
>
>and, interestingly CD45 was negative.
>
>We could find CD45-bright normal lymphocytes on CD45-RALS (right angle
>light scattle) dot plot thus false-negative for CD45 of these leukemic cells
>was ruled out.
>
>Anti-CD45 monoclonal antibody (Beckton-Dickinson Immunocytometry Systems,
>Cat No. 347463, USA) clone 2D1 conjugated with FITC (IgG1) was used at that
>time and we confirmed this CD45 negativity with immunostain on bone marrow
>aspirate smears using DAKO monoclonal antibody.
>
>Molecular and cytogenetic studies were also performed and demonstrated
>minor bcr/abl (e1a2) rearrangement and t(9;22), respectively.
>
>We concluded this case as a CD45-negative acute biphenotypic (myeloid and B
>lymphoid)leukemia.
>
>I tried to find out previously reported cases of CD45-negative acute leukemia
>but failed except some lymphomas.
>
>My questions are;
>
>1. Is this case the first one of CD45-negative acute leukemia?
>
>2. If it is not, could any one kindly tell
>me his/her experience or
> the source of literature of reported cases?
>
>3. If it is the first one, I want to establish a new cell line with this case.
> Could you give me a good reference or tips in doing this work?
>
>Any comment will be greatly appreciated.
>Thanks in advance.
>
>==================================
>Chang-Seok Ki, MD
>3rd-year Resident
>Dept. of Clinical Pathology
>Samsung Medical Center
>E-mail. kcdol@samsung.co.kr
>Tel. 82-2-3410-2707
>Fax. 82-2-3410-2719
>==================================
Maryalice Stetler-Stevenson
Director Flow Cytometry Unit
Laboratory of Pathology, NCI, NIH
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