Flow cytometric analysis of CD64 expression pattern and density in the diagnosis of acute promyelocytic leukemia: a multi-center study in Shanghai, China

Min Liu; Xiangqin Weng; Shenglan Gong; Hui Chen; Jing Ding; Mengqiao Guo; Xiaoxia Hu; Jianmin Wang; Jianmin Yang; Gusheng Tang

doi:10.18632/oncotarget.20814

Flow cytometric analysis of CD64 expression pattern and density in the diagnosis of acute promyelocytic leukemia: a multi-center study in Shanghai, China

Oncotarget. 2017 Sep 11;8(46):80625-80637. doi: 10.18632/oncotarget.20814. eCollection 2017 Oct 6.

Authors

Min Liu^#¹, Xiangqin Weng^#², Shenglan Gong¹, Hui Chen¹, Jing Ding¹, Mengqiao Guo¹, Xiaoxia Hu¹, Jianmin Wang¹, Jianmin Yang¹, Gusheng Tang¹

Affiliations

¹ Department of Hematology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
² Institute of Hematology, Ruijin Hospital, Jiaotong University, Shanghai, China.

^# Contributed equally.

Abstract

No unified immunophenotypic profiles and corresponding analytic strategies have been established for the rapid diagnosis of acute promyelocytic leukemia (APL) using flow cytometry (FCM). Here we describe a characteristic immunophenotypic panel that can rapidly and accurately distinguish APL from other types of adult acute myeloid leukemia (AML) using only FCM. By comparing APL cells and non-APL AML cells that share APL common immunophenotypes (CD34^-CD117⁺HLA^-DR^-) we found that CD64 was a significant factor that differentiated APL from other AMLs. Further retrospective analyses of 205 APL and 629 non-APL AML patients from different hematology centers showed that either the CD64^{dim and homo}CD13^+homo CD33^+homoMPO⁺ (myeloperoxidase) CD11c^- panel or the CD64^{dim and homo}CD13^+homo CD33^+homoMPO⁺ CD11c⁺CD10^-CD117⁺ SSC^high (high side scatter signal) panel could distinguish APL from non-APL AML patients with nearly 100% sensitivity, specificity and accuracy. Moreover, relative quantification of CD64 expression enhanced the applicability of our APL diagnostic immunophenotypic panels (ADI-panels) in different hematology centers. Application of the ADI-panels will decrease diagnosis time and improve personalized treatment for APL, a life-threatening disease with very rapid progression.

Keywords: APL diagnostic immunophenotypic panel; acute promyelocytic leukemia (APL); diagnostic performance; flow cytometry.