medigraphic.com

2017, Número 2

<< Anterior Siguiente >>

Rev Hematol Mex 2017; 18 (2)


Expresión de CD19 y CD22 en pacientes con leucemia linfoblástica aguda: relación con la edad y variantes morfológicas

Calderón-García J, Ramos-Peñafiel CO, Palmeros-Morgado G, Rozen-Fuller E, Santoyo-Sánchez A, Mendoza-García E, Olarte-Carrillo I, Martínez-Tovar A, Collazo-Jaloma J

Idioma: Español
Referencias bibliográficas: 42
Paginas: 58-67
Archivo PDF: 274.09 Kb.


RESUMEN

Antecedentes: la citometría de flujo es una herramienta diagnóstica aplicada en casos de leucemia linfoblástica aguda para identificar los marcadores de las clonas neoplásicas y clasificar la estirpe y grado de maduración.
Objetivo: establecer la frecuencia de expresión de los marcadores CD19 y CD22 e identificar si existe variación de expresión entre los diferentes grupos de edad.
Material y Método: estudio retrospectivo, transversal, observacional, basado en los registros de pacientes atendidos de julio de 2009 a junio de 2015 con diagnóstico de leucemia linfoblástica aguda de novo. Las muestras para inmunofenotipo por citometría de flujo fueron médula ósea o sangre periférica en pacientes con hiperleucocitosis o difícil toma de médula ósea; las muestras debían contener más de 20% de blastos.
Resultados: se estudiaron 208 casos, con media de edad de 32 (2-88) años. El 68% (n=141) fueron muestras de médula ósea y el resto de sangre periférica (32%, n=67). Se identificó que 193 casos (93%) mostraban inmunofenotipo de línea B, 12 de estirpe T (5.5%) y 3 fueron no clasificables (1.5%). La variante B común fue el fenotipo más frecuente en todos los grupos de edad. El 90% de los casos (n=176) fueron CD22+, con media de expresión de 63%. El 91% (n=179) fue CD19+, con media de expresión de 76%. La edad no influyó en la expresión de estos marcadores (p›0.05).
Conclusiones: los marcadores celulares analizados se expresaron frecuentemente, sin afectarse por la edad del paciente. Es indispensable la realización del inmunofenotipo en los pacientes con leucemia linfoblástica aguda para ofrecerles tratamientos altamente específicos.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Paul S, Kantarjian H, Jabbour EJ. Adult acute lymphoblastic leukemia. Mayo Clin Proc 2016;91:1645-66.

  2. Mathisen MS, Kantarjian H, Thomas D, O’Brien S, Jabbour E. Acute lymphoblastic leukemia in adults: encouraging developments on the way to higher cure rates. Leuk Lymphoma 2013;54:2592-600.

  3. Woo J, Baumann A, Arguello V. Recent advancements of flow cytometry: new applications in hematology and oncology. Expert Rev Mol Diagn 2014;14:67-81.

  4. van Dongen JJM, Orfao A. EuroFlow: Resetting leukemia and lymphoma immunophenotyping. Basis for companion diagnostics and personalized medicine. Leukemia 2012;26:1899-907.

  5. Donnenberg AD, Donnenberg VS. Rare-event analysis in flow cytometry. Clin Lab Med 2007;27:627-52.

  6. Ruiz-Argüelles A, Rivadeneyra-Espinoza L, Duque RE, Orfao A, Latin American Consensus Conference. Report on the second Latin American consensus conference for flow cytometric immunophenotyping of hematological malignancies. Cytom Part B Clin Cytom 2006;70B:39-44.

  7. Béné MC, Nebe T, Bettelheim P, Buldini B, Bumbea H, Kern W, et al. Immunophenotyping of acute leukemia and lymphoproliferative disorders: a consensus proposal of the European LeukemiaNet Work Package 10. Leukemia 2011;25:567-74.

  8. Bikoue A, George F, Poncelet P, Mutin M, Janossy G, Sampol J. Quantitative analysis of leukocyte membrane antigen expression: Normal adult values. Cytometry 1996;26:137-47.

  9. Béné MC, Castoldi G, Knapp W, Ludwig WD, et al. Proposals for the immunological classification of acute leukemias. European Group for the Immunological Characterization of Leukemias (EGIL). Leukemia 1995;9:1783-6.

  10. Béné MC, Bernier M, Castoldi G, Faure GC, Knapp W, Ludwig WD, et al. Impact of immunophenotyping on management of acute leukemias. Haematologica 1999;84:1024-34.

  11. Aziz SA, Sharma SK, Sabah I, Jan MA. Prognostic significance of cell surface phenotype in acute lymphoblastic leukemia. South Asian J cancer 2015;4:91-4.

  12. Miles RR, Arnold S, Cairo MS. Risk factors and treatment of childhood and adolescent Burkitt lymphoma/leukaemia. Br J Haematol 2012;156:730-43.

  13. Khalidi HS, Chang KL, Medeiros LJ, Brynes RK, Slovak ML, Murata-Collins JL, et al. Acute lymphoblastic leukemia. Survey of immunophenotype, French-American-British classification, frequency of myeloid antigen expression, and karyotypic abnormalities in 210 pediatric and adult cases. Am J Clin Pathol 1999;111:467-76.

  14. Sikaria S, Aldoss I, Akhtari M. Monoclonal antibodies and immune therapies for adult precursor B-acute lymphoblastic leukemia. Immunol Le tt 2016;172:113-23.

  15. Farhadfar N, Litzow MR. New monoclonal antibodies for the treatment of acute lymphoblastic leukemia. Leuk Res 2016;49:13-21.

  16. Hladnik L, Augustin K, DeFrates S. Advancements in therapy for acute lymphoblastic leukemia: Blinatumomab. J Adv Pract Oncol 2016;7:76-82.

  17. Batlevi CL, Matsuki E, Brentjens RJ, Younes A. Novel immunotherapies in lymphoid malignancies. Nat Rev Clin Oncol 2015;13:25-40.

  18. Daver N, O’Brien S. Novel Therapeutic strategies in adult acute lymphoblastic leukemia – A focus on emerging monoclonal antibodies. Curr Hematol Malig Rep 2013;8:123-31.

  19. Thomas DA, O’Brien S, Faderl S, Garcia-Manero G, et al. Chemoimmunotherapy with a modified hyper-CVAD and rituximab regimen improves outcome in de novo Philadelphia chromosome-negative precursor B-lineage acute lymphoblastic leukemia. J Clin Oncol 2010;28:3880-9.

  20. Maury S, Chevret S, Thomas X, Heim D, Leguay T, Huguet F, et al. Rituximab in B-Lineage Adult Acute Lymphoblastic Leukemia. N Engl J Med 2016;375:1044-53.

  21. Kantarjian HM, DeAngelo DJ, Stelljes M, Martinelli G, et al. Inotuzumab ozogamicin versus standard therapy for acute lymphoblastic leukemia. N Engl J Med 2016;375:740-53.

  22. Raetz EA, Cairo MS, Borowitz MJ, Lu X, Devidas M, Reid JM, et al. Re-induction chemoimmunotherapy with epratuzumab in relapsed acute lymphoblastic leukemia (ALL): Phase II results from Children’s Oncology Group (COG) study ADVL04P2. Pediatr Blood Cancer 2015;62:1171-5.

  23. Chevallier P, Huguet F, Raffoux E, Etienne A, Leguay T, Isnard F, et al. Vincristine, dexamethasone and epratuzumab for older relapsed/refractory CD22+ B-acute lymphoblas tic leukemia patients: a phase II study. Haematologica 2015;100:e128-31.

  24. Topp MS, Gokbuget N, Zugmaier G, Klappers P, Stelljes M, Neumann S, et al. Phase II trial of the anti-CD19 bispecific T Cell-Engager blinatumomab shows hematologic and molecular remissions in patients with relapsed or refractory B-precursor acute lymphoblastic leukemia. J Clin Oncol 2014;32:4134-40.

  25. Kantarjian HM, Stein AS, Bargou RC, Grande Garcia C, Larson RA, Stelljes M, et al. Blinatumomab treatment of older adults with relapsed/refractory B-precursor acute lymphoblastic leukemia: Results from 2 phase 2 studies. Cancer 2016;122:2178-85.

  26. Gökbuget N, Kelsh M, Chia V, Advani A, Bassan R, Dombret H, et al. Blinatumomab vs historical standard therapy of adult relapsed/refractory acute lymphoblastic leukemia. Blood Cancer J 2016;6:e473.

  27. Gujral S, Badrinath Y, Kumar A, Subramanian PG, Raje G, Jain H, et al. Immunophenotypic profile of acute leukemia: Critical analysis and insights gained at a tertiary care center in India. Cytom Part B Clin Cytom 2009;76B:199-205.

  28. Basturk A, Akinci S, Hacibekiroglu T, Guney T, et al. Prognostic significance of flow cytometry findings in Turkish adult acute leukemia patients. Eur Rev Med Pharmacol Sci 2015;19:3360-6.

  29. Sędek Ł, Bulsa J, Sonsala A, Twardoch M, et al. The immunophenotypes of blast cells in B-cell precursor acute lymphoblastic leukemia: How different are they from their normal counterparts? Cytom Part B Clin Cytom 2014;86:329-39.

  30. Chen W, Karandikar NJ, McKenna RW, Kroft SH. Stability of leukemia-associated immunophenotypes in precursor B-lymphoblastic leukemia/lymphoma. Am J Clin Pathol 2007;127:39-46.

  31. Marsán Suárez V, Cos Padrón Y, Sánchez Segura M, Socarrás Ferrer BB, et al. Relevancia biológica y clínica del inmunofenotipaje celular en la leucemia linfoide aguda del niño. Rev Cuba Hematol Inmunol y Hemoter 2008;24(1).

  32. Chevallier P, Eugene T, Robillard N, Isnard F, et al. 90Ylabelled anti-CD22 epratuzumab tetraxetan in adults with refractory or relapsed CD22-positive B-cell acute lymphoblastic leukaemia: a phase 1 dose-escalation study. Lancet Haematol 2015;2:e108-17.

  33. Li H-F, Meng W-T, Jia Y-Q, Jiang N-G, Zeng T-T, Jin Y-M, et al. Development-associated immunophenotypes reveal the heterogeneous and individualized early responses of adult B-acute lymphoblastic leukemia. Medicine (Baltimore) 2016;95:e4128.

  34. Oliveira E, Bacelar TS, Ciudad J, Ribeiro MCM, Garcia DRN, Sedek L, et al. Altered neutrophil immunophenotypes in childhood B-cell precursor acute lymphoblastic leukemia. Oncotarget 2016;7:24664-76.

  35. Novoa V, Núñez NA, Carballo OG, Lessa CF. [Aberrant immunophenotypes in acute leukemia in a Buenos Aires’ hospital population]. Medicina (B Aires) 2013;73:9-16.

  36. Czuczman MS, Dodge RK, Stewart CC, Frankel SR, Davey FR, Powell BL, et al. Value of immunophenotype in intensively treated adult acute lymphoblastic leukemia: cancer and leukemia Group B study 8364. Blood 1999;93:3931-9.

  37. Udomsakdi-Auewarakul C, Promsuwicha O, Tocharoentanaphol C, Munhketvit C, Pattanapanyasat K, Issaragrisil S. Immunophenotypes and outcome of Philadelphia chromosome-positive and -negative Thai adult acute lymphoblastic leukemia. Int J Hematol 2003;78:337-43.

  38. Gupta A, Pal A, Nelson SS. Immunophenotyping in Acute Leukemia: A Clinical Study. Int J Sci Study 2015;3:129-36.

  39. Ludwig WD, Rieder H, Bartram CR, Heinze B, Schwartz S, Gassmann W, et al. Immunophenotypic and genotypic features, clinical characteristics, and treatment outcome of adult pro-B acute lymphoblastic leukemia: results of the German multicenter trials GMALL 03/87 and 04/89. Blood 1998;92:1898-909.

  40. Soriano-Villalobos I, Vásquez-Danjanovic E, Niquén-Fiestas S, Fernández-Infantes M, et al. Caracterización inmunofenotípica de leucemias agudas diagnosticadas en un Hospital Nivel III en el periodo 2010-2013, Chiclayo-Perú. Rev cuerpo Médico HNAAA 2015;8:5-8.

  41. Weinkauff R, Estey EH, Starostik P, Hayes K, et al. Use of peripheral blood blasts vs bone marrow blasts for diagnosis of acute leukemia. Am J Clin Pathol 1999;111:733-40.

  42. Rezaei A, Adib M, Mokarian F, Tebianian M, Nassiri R. Leukemia markers expression of peripheral blood vs bone marrow blasts using flow cytometry. Med Sci Monit 2003;9:CR359-62.tic leukemia patients: a phase II study. Haematologica 2015;100:e128-31.




2020     |     www.medigraphic.com