Analysis of Cytoplasmic Antigens in Acute Leukemia by Flow Cytometry

Abstract

The expression of cytoplasmic antigens in 77 cases of acute leukemia were analyzed by flow cytometry using the following monoclonal antibodies: CD3, CD22, anti-myeloperoxidase (MPO-7) and anti-μ-heavy chain.
CD22 antigen was detected in the cytoplasm of all non-T-ALL patients excluding one not-tested patient. In two patients with unclassified ALL, surface CD22 antigen was not expressed but cytoplasmic CD22 antigen was strongly expressed.
Three out of 9 patients with common ALL were cytoplasmic μ-heavy chain-positive, so these patients were diagnosed as Pre-B ALL. In four out of 8 patioents with T-ALL, CD3 antigen was not expressed on the cell surface membrane. Howover all of T-ALL patients excluding one non-tested patient were cytoplasmic CD3-positive.
The cytoplasmic expression of myeloperoxidase antigen was detected in twenty out of 21 patients with acute non-lymphoblastic leukemia (ANLL). One megakaryocytic leukemia patient was MPO-negative. In two ANLL patients, the percentage of MPO for conventional cytochemical staining was undetectable or low, but MPO antigens were positive (77% and 70%) for flow cytometric analysis. All of 46 non-T ALL patients were cytoplasmic MPO-negative, however 4 out of 10 T-ALL patiens were cytoplasmic MPO-positive.
The study proved that the analysis of cytoplasmic CD3, CD22, μ-chain and MPO antigens were very useful to define the cell lineage of leukemia and to classify ALL and ANLL. It is nessesary to study further whether the expression of MPO in the cytoplasm of T-ALL was non-specific reaction or whether MPO precursors are expressed in the cytoplasm of T-ALL.