Diagnostic value of immunophenotype between acute promyelocytic leukemia and acute myeloid leukemia with mutated NPM1
Objective To evaluate the diagnostic value of immunophenotype between acute promyelocytic leukemia(APL)and acute myeloid leukemia with mutated NPM1(NPM1+AML).Methods The immunophenotypic characteristics of 98 APL and 88 NPM1+AML were analyzed by flow cytometry,retrospectively.The Chi-square tests were used to compare the differences of antigen expression of two groups,as well as the sensitivities,specificities and the area under the curves(AUC)of antigens or antigen combinations were analysed by drawing the receiver operating characteristic curve.Results APL was characterized by positive for CD117,CD13,CD33,CD64 and myeloperoxidase(MPO).The majority showed CD11b and HLA-DR negative.Of the 48(54.5％)cases lacking monocyte differentiation in NPM1+AML,27(30.9％)showed an APL-like immunophenotype.Side scatters(SSCs)of NPM1+AML cells were lower than those of all hypergranular APL,which was easily distinguished each other,but SSCs of NPM1+AML cells were similar to those of hypogranular APL.CD2 and CD34 positive APL-like cases were significantly less than hypogranular APL(P=0.003 and P=0.001).The combination of CD64 positive,uniform CD13 and strong CD33 expression was useful for distinguishing hypogranular APL and APL-like NPM1+AML with a sensitivity of 100.0％and a specificity of 96.3％,respectively.The AUC was 0.981(95％CI:0.939-1.000).Conclusion APL and NPM1+AML have similar immunophenotypic characteristics,but can be distinguished by SSC,CD13,CD33,CD64,CD2 and CD34.
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