Flow cytometric analysis of acute leukemia cases in Aseer area of the kingdom of Saudi Arabia

Abstract EN

Objective: To determine and to estimate the occurrence of acute leukemia's in Aseer Area, Saudi Arabia And to identify the common immunophenotypes of acute leukemia using flow cytometric analysis.

Methods: Thirty five patients were included in this descriptive study which was conducted at the Armed Forces Hospital in collaboration with Aseer central Hospital during the period from January 2009 to January 2010, peripheral blood and bone marrow samples were collected from those patients suspected with acute leukemia.

Laboratory investigations comprised blood and bone marrow films, complete blood count as well as flow cytometric analysis.

Data were analyzed using the SPSS 15 statistical package.

Results: Thirty five cases were diagnosed as acute Leukemia ones and were classified as Acute Myelogenous Leukemia (AML), n=13( 37.1%) and Acute Lymphoblastic Leukemia (ALL), n=22 (62.9%).

Their diagnosis was determined according to the standard French- American- British (FAB) criteria in addition to immunophenotyping.

Leukemia was diagnosed among adults in 68.6% whereas among children with age less than or equal to 12 years in 31.4%.

The patient”s age ranged from one year to 74 years with a mean of 26.5 years.

Twenty one(60%) were males and 14 (40%) were females with a male:female ratio of 1.5:1.

For ALL the most common immunophenotype was Pre-B ALL (63.6%), followed by Pre-T ALL (31.8%), and B-ALL (4.5%).

For AML it was found that M1/M2 (38.5%), M4/M5 (30.8%), M3 (23.0%), and M0 (7.7%) were detected.

Conclusion: Immunophenotypic studies are essential to distinguish acute lymphoblastic leukemia (ALL) from minimally differentiated acute myeloid leukemia (AMLM0) and to classify ALL into immunologic subtypes.

Supporting conventional methods( CBC, blood and bone marrow films ) with Flow cytometry proved to be important for final diagnosis as flow cytometry was found to be especially useful in the correct identification of AML M0 and differentiation of acute promyelocytic leukemia (APL) from AML M1/M2.

It is recommended to conduct more research to determine genotypes and phenotypes of different leukemia markers.