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>To all clinical flow people,
>
>We have had an unusual case of an 0acute leukemia which I would like to
>share with you, hoping you have seen something like this before and can
>explain our flow findings.
>
>This is a 7 year old female with the following CBC findings:
>WBC: 15.3
>RBC: 3.26
>Hgb: 9.5
>Plt: 26,000
>blasts: 16%
>
>Cytochemistry: negative for myeloperoxidase
>The CSF showed also leukemic infiltrate.
>
>Review of the marrow aspirate shows a predominance of blasts. The blasts
>range in size from small to large with occasionally prominent nucleoli and
>generally scant cytoplasm. No Auer rods are identified.
>
>Flow cytometric analysis showed the blasts to have both increased FALS and
>SS and to be positive for CD45 (weak to moderate), CD10 (weak to moderate),
>and TdT. CD19 was negative!! The blasts were also negative for CD2, CD5,
>CD7, CD13, CD15, CD33, CD11c, and CD34. There was some weak positivity for
>CD20 and cytoplasmic IgM which I am inclined to interpret as
>negative/non-specific.
>DNA content analysis showed a near tetraploid/DNA aneuploid population with
>a DNA Index of 1.95.
>
>This case was signed out as acute lymphoid leukemia with undifferentiated
>phenotype.
>
>We were really puzzled by the absence of CD19 as well as by the high DNA
>Index in a B-ALL. Also, aren't undifferentiated ALL's usually CD45 negative?
>
>
>If you have ever encountered a case like this, we would greatly appreciate
>your input!
>Andrea Illingworth
>Dahl-Chase Diagnostic Services/Flow Cytometry
>333 State Street
>Bangor, Maine 04401
>(207)990-4855
>
>
>
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CD-ROM Vol 3 was produced by Monica M. Shively and other staff at the
Purdue University Cytometry Laboratories and distributed free of charge
as an educational service to the cytometry community.
If you have any comments please direct them to
Dr. J. Paul Robinson, Professor & Director,
PUCL, Purdue University, West Lafayette, IN 47907.
Phone: (765)-494-0757;
FAX(765) 494-0517;
Web