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Phnotipic and molecular features of acute lymphoblastic leukemia in Recife - PE / Avaliação imunofenotipica, estudo do indice de DNA e de alterações moleculares em celulas blasticas de pacientes portadores de leucemia linfoide aguda diagnosticados na Fundação Hemope




Acute Lymphoblastic Leukemia (ALL) is a disease that occurs primarily in children (75-80%) and represents only 20% of adults leukemia. Some c1inical and laboratorial research have focused on stratifying patients into various risk groups based on known prognostic features that play a critical role in directing therapy for ALL. We have studied biological characteristics of ALL (adults and children) of patients attended on Hemope Foundation from March 2004 to March 2006. The immunophenotyping at diagnosis was perfonned by a dual color two stage protocol. Expression of each antigen studied was measured by mean fluorescence intensity (MFI) by flow cytometry using the Paint-a-gate software. RT-PCR was perfonned to detect specific molecular alterations. We analyzed 49 patients: 18 children (:S 18 years old) and 31 adults. Eleven were T ALL with median age of 19 years and 38 were B ALL (7 pre-pre B, 15 common, 13 pre B and 3 without c1assification) :with median age of 29 years. Concerning gene rearrangements, BCR/ABL was detected in 5 patients (4 BCR/ABL p190 and 1 BCR/ABL p210), E2A/PBXl in 2 patients and AF4/MLL in 2 patients. TEL/AML1 couldn t be found in any case examined. Hyperdiploidy was observed in 5 patients. The percentage of cells in phase S showed a large variation, but did not differ in children or adults nor between B ALL and T ALL. Our results show that the antibodies used were sufficient to c1assify the cases. The quantitative approach was able to disclose better the maturation abnonnalities of the leukemic blasts. The frequency of hyperdiploid cases was similar to that found in the literature. The proliferation rate was variable but had no relationship with age and ALL type. The molecular aberrations were associated with specific ALL subtypes, as already described in the literature. Even so, the frequency of BCR/ABL in adults was diminished


flow cytometry citometria de fluxo diagnostic acute lymphoblastic leukemia diagnostico leucemia linfoide aguda