Acute Lymphoblastic Leukemia (B-ALL) with co-expression of CD33 and CD13
- pdf |
- DOI: https://doi.org/10.15562/bmj.v12i1.4226 |
- Published: 2023-03-17
Open Access & Peer Reviewed Multidisciplinary
Journal of Medical Sciences
Journal of Medical Sciences
Abstract
Link of Video Abstract: https://www.youtube.com/watch?v=AC472eZBXII
Background: Most acute leukemias can be classified into myeloid or lymphoid strains based on the expression of several specific phenotypes. However, some cases of acute leukemia express both phenotypes (myeloid and lymphoid phenotypes). To establish the diagnosis of acute leukemia with co-expression of myeloid markers or mixed phenotype acute leukemia (MPAL), we need a system that can differentiate between the two, namely by using the scoring system from The European Group for the Immunological Characterization of Leukemias (EGIL) and The World Health Organization (WHO) classification of tumors of the hematopoietic and lymphoid tissues 2016.
Case Presentation: A 10-year-old boy was admitted to the hospital because of repeated nosebleeds for 3 weeks before entering the hospital. Patients also complain of decreased appetite, nausea, vomiting, and joint pain. On physical examination, anemic conjunctiva was found, and no abnormalities were found on other physical examinations. Hemoglobin examination: 8.2 g/dl, leukocytes 112.10×103/µl, platelets 10×103/µl. Examination of peripheral blood smear: acute lymphoblastic leukemia. Examination results of bone marrow aspiration acute lymphoblastic leukemia (ALL L1). Immunophenotype analysis found blast cells with positive expression for CD34, CD79a, CD10, HLA-DR, CD33 and CD13.
Conclusion: The diagnosis in this patient was B-ALL with myeloid marker co-expression based on the EGIL and WHO scoring systems.
References
- Weinberg OK, Arber DA. Mixed-phenotype acute leukemia: Historical overview and a new definition. Leukemia. 2010;24(11):1844–1851.
- Mejstrikova E, Volejnikova J, Fronkova E, Zdrahalova K, Kalina T, Sterba J, et al. Prognosis of children with mixed phenotype acute leukemia treated on the basis of consistent immunophenotypic criteria. Haematologica. 2010;95(6):928–935.
- Supriyadi E, Veerman AJP, Sutaryo, Purwanto I, Vd Ven PM, Cloos J. Myeloid antigen expression in childhood acute lymphoblastic leukemia and its relevance for clinical outcome in Indonesian ALL-2006 protocol. J Oncol. 2012;2012(1):8–12.
- Terwilliger T, Abdul-Hay M. Acute lymphoblastic leukemia: a comprehensive review and 2017 update. Blood Cancer J. 2017;7(6):e577–e577.
- Kavianpour M, Ketabchi N, Saki N. Prognostic significance of aberrant expression of CD markers in acute lymphoblastic leukemia. memo - Mag Eur Med Oncol. 2017;10(3):164–169.
- Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127(20) :2391–2405.
- Putri KW, Ugrasena IDG, Hernaningsih Y. Epidemiological Study of Clinical and Laboratory Profiles of Patients with Acute Lymphoblastic Leukemia at Dr. Soetomo Hospital Surabaya. Biomolecular and Health Science Journal. 2019;2(1): 48-52.
- Prabawa IPY, Mahartini NN, Herawati S, Mulyantari NK. Acute Erythroleukemia (AML-M6) in one-year-old boy: a case report. Bali Medical Journal. 2022;11(3): 1420–1425.
- Heriawati SO, Harsono T, Bachtiar MM, Hernaningsih Y. Blood Cells Classification for Identification of Acute Lymphoblastic Leukemia on Microscopic Images Using Image Processing. In 2021 International Electronics Symposium (IES). 2021;1:215-220.
- Permatasari CA, Hajat A, Sedana MP. Diagnostic Testing of Hematology Analyzer Equipped with WPC Channel Scattergram in Determining Strains of Hematological Malignancies. Research Journal of Pharmacy and Technology. 2022;15(9):4005-4011.
- Hidayati SN. Correlative Study Between Nutritional Status and Remission Outcome in Childhood Acute Lymphoblastic Leukemia in Dr. Soetomo General Hospital Surabaya. Biomolecular and health science journal. 2019;2(1):27-30.
- Budiana ING. Association of b-cell lymphoma protein-2 and caspase-3 expression in ovarian cancer. Indonesia Journal of Biomedical Science. 2014;7(2):67–73.
- Cahyadi A, Ugrasena I, Andarsini MR, Larasati MCS, Aryati A, Arumsari DK. Relationship between bax and bcl-2 protein expression and outcome of induction phase chemotherapy in pediatric acute lymphoblastic leukemia. Asian Pacific Journal of Cancer Prevention. 2022;23(5):1679-1685.
How to Cite
Kustiah, & Hernaningsih, Y. (2023). Acute Lymphoblastic Leukemia (B-ALL) with co-expression of CD33 and CD13. Bali Medical Journal, 12(1). https://doi.org/10.15562/bmj.v12i1.4226
