Debi Prasad Mishra, Bodhisatwa Behera, Kripa Elizabeth John
BACKGROUND Classification of acute leukaemia is gaining importance as the treatment continues to evolve for specific genetic and pathogenetic subgroups. AIMS: A well organised panel of antibodies can be used for immunophenotyping of acute leukaemia by Immunohistochemistry (IHC) when only a Bone marrow trephine biopsy (BMTB) specimen is available for study. In other words when Flow cytometry (FCM) cannot be performed because of lack of availability of technology or inadequacy of bone marrow aspiration (BMA). MATERIALS AND METHODS The bone marrow biopsy taken from these patients were processed to obtain formalin-fixed paraffin-embedded tissue blocks. The sections taken were then processed for heat induced antigen retrieval and stained with primary antibodies of the IHC panel. The IHC panel consisted of CD45, CD34, CD117, TdT, PAX5, CD20, CD10, CD3, MPO and CD68. RESULTS A total of 115 cases were studied out of which 48 (47.9%) cases of AML and 60 (52.1) cases of ALL were identified. The specimens were from 53 (46.1%) females and 62 (53.9%) males, with average age of 24.6 years (ranging from 3 months to 80 years). CONCLUSION Further categorisation was done according to the differential expression of the markers in the panel of antibodies which finally resulted in the following subtypes, AML with Minimal Differentiation (AML MD – 6 (5.2%)), AML without maturation and with maturation (AML Myeloid - 19 (16.5%)), Acute Promyelocytic Leukaemia (APL - 20 (17.4%)), Acute Myelomonocytic Leukaemia (AML MM - 2 (1.7%)), Acute Monoblastic/ Monocytic Leukaemia (AML M - 1 (0.9%)), Acute Leukaemia Others (AL Oth - 7 (6.1%)), B cell Acute Lymphoblastic Leukaemia (B ALL - 58 (50.5%)) and T cell Acute Lymphoblastic Leukaemia (T ALL - 2 (1.7%)).
