Dear Paula,
Thank you for your reply. The original flow cytometry done by an unknown
source was disgustingly inadequate. CD3-3%, CD4-1%, CD8-1%, CD5-2%, CD19-0%,
CD20-0%, CD16+CD56-0%. They did not do any further markers to determine the
identity of the cells. A morphological diagnosis was made of T cell
prolymphocytic leukaemia and the patient was treated with Prednisolone and
Chlorambucil.
The patient's WCC dropped from the initial 200 x 10^9/L to 12 x10^9/L by the
time she was referred to our hospital. These drugs would probably have no
effect on the cells of an AML.
So although the case morphologically appear to be of T cell origin and has
responded to the treatment as such. Immunologically it is most likely an AML
with aberrant CD7 expression.
In there lies the dilemma.
Thank you for your help.
Regards
Lynette Tytherleigh
-----Original Message-----
From: Paula Imus [mailto:pif@mail.nih.gov]
Sent: Thursday, 26 September 2002 4:41
To: cyto-inbox
Subject: Re: An unusual clinical case: seeking clinical opinions
Hi Lynette,
Myeloid leukemia cells can be CD7 positive. What was the initial flow?
Paula
At 10:25 AM 9/25/2002 +0800, you wrote:
>Dear Flow Users
>
>A patient was referred to the Haematology Department of Fremantle Hospital
>on 20/09/02 after being treated for a suspected CLL/prolymphocytic
leukaemia
>with a WCC of 200 X10^9/L on 02/08/02. Prednisolone 50mg was given for
>approximately one week and Chlorambucil 6mg for 7 days.
>
>The WCC was 12.0 x 10^9/L on presentation at Fremantle Hospital.
>Morphologically the white cells appeared to be T cell prolymphocytes.
>
>Bone marrow and peripheral blood immunophenotyping was done.
>The abnormal cells made up 60% of the bone marrow cells. They were gated
>using CD45-PC5/LSS and had forward and side scatter characteristics of
>lymphocytes. They were positive for CD7, CD11b, CD13, CD33, CD34, CD45,
>CD117, and weakly positive for HLADR and negative for CD2, CD3, CD4, CD5,
>CD8, CD10, CD14, CD15, CD16+CD56, CD19, CD20, CD61, CD71, CD79b, cCD3,
cMPO,
>and cCD79a.
>
>Comments would be greatly appreciated.
>
>Regards
>
>Lynette Tytherleigh
>
>Haematology Department
>Fremantle Hospital
>Alma St
>Fremantle 6959
>Western Australia
>Phone: 08 94312459
>Email: Lynette.Tytherleigh@health.wa.gov.au
Paula Imus
Flow Cytometry
LP, NCI, NIH
10 Center Drive MSC-1500
Bethesda, Md. 20892-1500
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