Flow Cytometry Immunophenotypic Features of Pure Erythroid Leukemia and the Distinction From Reactive Erythroid Precursors

Authors

Hong Fang
Sa A Wang
M James You
Shimin Hu
Roberto N Miranda
Zhenya Tang
Pei Lin
Jeffrey L Jorgensen
Jie Xu
Beenu Thakral
Ellen J Schlette
Siba El Hussein
Carlos Bueso-Ramos
L Jeffrey Medeiros
Wei Wang

Publication Date

11-1-2022

Journal

Cytometry Part B: Clinical Cytometry

DOI

10.1002/cyto.b.22095

PMID

36156384

Abstract

BACKGROUND: The immunophenotype of pure erythroid leukemia (PEL) as determined by flow cytometry immunophenotypic analysis is not well characterized. The immunophenotypic difference between PEL and reactive conditions is under-explored.

METHODS: We assessed and compared the immunophenotype of 24 PEL cases and 28 reactive cases containing early erythroid precursors by flow cytometry.

RESULTS: The neoplastic erythroid cells in all PEL cases were positive for CD36 and CD71. CD45 was also positive in all cases, but the expression level was often dimmer than granulocytes. CD117 expression ranged from partial to uniform, and CD235a was often only positive in the CD117-dim to negative cells, corresponding to more differentiated subset. PEL cases frequently (87%) showed decreased or negative CD38 expression, contrasting to reactive early erythroid precursors that showed bright CD38 (p <  0.0001). CD7 (25%) and CD13 (29%) aberrant expressions were only observed in PEL but not in the reactive erythroid cells. Normal early erythroid precursors in all reactive bone marrows showed partial expression of CD4; In contrast, aberrant CD4 expression was detected in 71% PEL cases, either uniformly positive (50%) or completely negative (21%). While normal/reactive bone marrows almost always contained a small subset of CD34-positive early erythroid precursors, the neoplastic pronormoblasts in all PEL cases were CD34 negative. Although not increased in number, CD34-positive myeloblasts were frequently detected in PEL and demonstrated an aberrant immunophenotype in 90% PEL cases.

CONCLUSIONS: PEL shows a distinctive immunophenotype which can be distinguished from reactive erythroid precursors by flow cytometry immunophenotyping.

Keywords

Humans, Immunophenotyping, Flow Cytometry, Bone Marrow, Cell Count, Leukemia

Published Open-Access

yes

Recommended Citation

Fang, Hong; Wang, Sa A; You, M James; et al., "Flow Cytometry Immunophenotypic Features of Pure Erythroid Leukemia and the Distinction From Reactive Erythroid Precursors" (2022). Faculty, Staff and Student Publications. 5171.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5171