(精选)【医学课件】 免疫标记的应用与评价教学课件.pptVIP

Acute myeloid leukaemia Acute myeloid leukaemia The blast % is lowered from 30% (FAB) to 20% (WHO) Median age of onset = 60 yrs Incidence 4 –10 / 100,000 Etiology Myeloblasts versus lymphoblasts Acute myeloid leukaemia Acute lymphoblastic leukaemia Acute myeloid leukaemia: cytochemistry Myeloperoxidase Sudan Black B Non-specific esterase a-naphthyl butyrate a-naphthyl acetate Cytochemistry: MPO Cytochemistry: NSE Cytochemistry Acute myeloid leukaemia: role of immunophenotyping Distinction of minimally differentiated AML from acute lymphoblastic leukaemia Recognition of AML-M7 Recognition of specific AML sub-categories (e.g CD56+ve AML) Diagnosis of biphenotypic leukaemia However, immunophenotyping is not mandatory in typical cases of AML, unlike in ALL where a phenotypic diagnosis is needed in every case Acute myeloid leukaemia: role of immunophenotyping Panel of monoclonal antibodies in classification of acute leukaemia Haemopoietic precursors: CD34, HLA-DR, Tdt, CD45 B-lineage: CD19, CD20, CD22, CD79a T-lineage: CD2, CD3, CD5, CD7 Myeloid: CD13, CD33, CD117, anti-MPO Megakaryocytic: CD41, CD61 Acute myeloid leukaemia with recurrent genetic abnormalities Acute myeloid leukaemia with t(8;21)(q22;q22); AML1/ETO Acute myeloid leukaemia with abnormal bone marrow eosinophils and inv(16)(p13q22) or t(16;16)(p13;q22); CBFb/MYH11 Acute promyelocytic leukaemia (AML with t(15;17)(q22;q12); PML/RARa and variants Acute myeloid leukaemia with 11q23 (MLL) abnormalities Acute myeloid leukaemia with t(8;21)(q22;q22); AML1/ETO t(8;21) is the commonest translocation in AML Associated with AML-M2 morphology Tumour masses (granulocytic sarcoma) Acute myeloid leukaemia with t(8;21)(q22;q22); AML1/ETO Morphology Large blasts, heavily granulated Frequent Auer rods Variable dysplasia in granulocytic series Rare cases with blast count 20% Immunophenotype CD13+ CD33+ anti-MPO+ CD19+ CD34+ CD56± Acute myeloid leukaemia with t(8;21)(q22;q22); AML1/ETO Acute myeloid leukaemia