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• W628427337 abstract "18032 Background: Kidwai Memorial Institute of Oncology is a cancer centre in India offering subsidized treatment to poor patients. Each year 350+ cases of acute leukemia are characterized by morphology and cytochemistry of bone marrow aspirate (BMA) smears. Conventional cytogenetics is available. Flow cytometry, (FC) available outside the centre is beyond the financial reach of most patients. In some cases, BMA is difficult to obtain because of a packed marrow/fibrosis. We attempted immunohistochemistry (IHC) on bone marrow biopsy (BMB) paraffin sections of 30 cases with a limited panel of antibodies. Methods: 30 cases were chosen to diagnose carcinoma/leukemia, lineage assignment ALL/AML M0 or to categorise ALL into T and B cell types. 6 available markers were used: MPO, Tdt, CD 3, CD 20, CD 68 and F8RA. The BMBs were fixed in 10% formalin, decalcified in 10% EDTA and routinely processed. A manual streptavidin biotin technique was used, with appropriate positive and negative controls. The slides were reviewed by 3 hematopathologists. 20% of the blasts taking the stain was considered positive. FC findings (4 cases), and karyotype (19 cases) were tabulated. Results: In 3 cases, morphology and IHC were suggestive of AML. In 15 cases, morphology was inconclusive. After IHC, a diagnosis of ALL was made in 10 cases, AML in 3 cases, including a child with extensive myelofibrosis. 2 cases of mixed lineage leukemia (MLL/ALL) were diagnosed. 11 cases of ALL were classified as T in 7 cases, and pre B in 4 cases. 5/7 T ALL cases had massive mediastinal nodes. In 1 case, cytokeratin and CD 45 were run in addition. Burkitt’s leukemia was diagnosed, confirmed by a complex karyotype including t(8:14)(q24;q32)10/19 cases had a normal karyotype. The rest showed a good correlation. Conclusions: 1. A limited panel of Tdt, MPO, CD 20 and CD 3 provide good information. 2. Our patients paid Rs 200 per marker, FC costs Rs 1000. 3. IHC can differentiate carcinoma from leukemia, diagnose ALL, differentiate T and B ALL, and help in the diagnosis of MLL. 4. Background staining by MPO hinders the diagnosis of AML. Therefore, IHC on BMB sections is valuable in the categorization of acute leukemia, particularly in under resourced laboratories. No significant financial relationships to disclose." @default.
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• W628427337 date "2008-05-20" @default.
• W628427337 modified "2023-09-25" @default.
• W628427337 title "Immunohistochemistry on bonemarrow paraffin sections for characterization of acute leukemia in an under resourced laboratory" @default.
• W628427337 doi "https://doi.org/10.1200/jco.2008.26.15_suppl.18032" @default.
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