Your question is not totally clear.With 54% blasts in the bone marrow , there is persistence/recurrence of disease in the marrow. The above notwithstanding, in many cases leukemic cells will have a dimmer CD45 expression which can help distinguish the two populations. Not infrequently, CD45 in ALL will be negative of quite dim as you experienced the first time. Please remember that you must be able also to differentiate also hematogones which would be somewhat dimmer than your blasts. In addition, from my experience ALL cells which are CD10 (+) are brighter than any other CD10(+) cells. >>> "Saldivar, Victor" <victor_saldivar@srhc.iwhs.org> 08/17/01 02:10PM >>> Dear Anna: I would appreciate your help. I've got this morning another of those very rare cases of pedi ALL with only 17% (dim) positive CD45 (BD Ab). I would like to know if you could share your views about the above with me and the FLOW audience at large, for further discussion. We have seen this in our lab, but rarely. Everytime something unusual comes, I jump and get nervous. I know it's not technical error in this case. Patient is 14 years, diagnosed with L1ALL in Sept'99, 76 % blasts; could'nt do FLOW, but cytospins showed Tdt+, CD10+, CD19 equivocal. The MPO, double esterase and Sudan Black were negative. BM chromies showed 47,XY,+X,add(21)(q22). The CFS has shown blasts on/off. He's received chemotherapy. Yesterday he returned for chek-up and shows pancytopenia without blasts, but the BM sohws 54% blasts. We could do BM FLOW that discloses CD45 17% (only!!), HLADR 91%,CD10 87%, CD19 82% and CD34 77%. The CD5 and Glycophorin are 5 and 16%. So, I'm looking for supportive evidence/experience that there are some CD45-ALLs, and if so, ?how many/how often. Thank you Anja and to those that may respond. Victor A. Saldivar-- San Antonio, TX
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