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About 80–85% of childhood ALL cases originates from B-cell precursor cells (BCP-ALL 7) whereas 10–15% of cases originate from T-cell precursors 8. The acute lymphoblastic leukemias (ALL) are a group of malignant hematological disorders, in which the pathological cells (blasts) originate from precursors of the lymphoid lineage 5, 6. In the last phase of mature B-cell, CD10 antigen disappears, CD38 significantly decreases, CD20 slightly decreases, while CD22 increases 3, 4, 13- 17, 19, 23, 24, 27. In the next stage of maturation, in type 3 hematogones (immature/transitional B-cells, H3) further increase of expression of CD20, CD45, and CD38 is observed, whereas the expression of CD10 decreases. In the next stage of type 2 hematogones (pre-B-II cells and H2), the expression of TdT and CD34 extinguishes, the expression of CD10 and CD22 slightly decreases and the levels of CD20, CD45, and CD38 increase. The expression levels of CD45 and CD22 are low (dim) and CD20 is very low. Type 1 hematogones (pre-B-I cells, H1) express high level of TdT, CD34, CD38, and also very high level of CD10. The arrows show the direction of maturation pathway. Gray fields marked with letters A–C represent spaces where normally these cells do not occur (so called empty spaces). Reproducible expression patterns of examined antigens on hematogones and mature B-cells shown on nine different 2-dimensional dot plots. © 2014 International Clinical Cytometry Society This novel and previously undescribed method has allowed the comparative analysis of antigen expression between leukemic blasts and different types of their normal counterparts. Multiparameter flow cytometry combined with the use of absolute antigen expression scale based on direct fluorescence measurement, has enabled a clear distinction between blasts in BCP-ALL cases and their normal counterparts. Conversely, CD10 − blasts showed significantly higher expression of CD45 than CD10 + blasts, and a higher rate of CD45 antigen overexpression than CD10 + blasts (54.5% vs. In contrast to the CD10 − blasts, the CD10 + blasts exhibited significantly higher levels of TdT, CD22, CD34 and CD20 expression. Among CD10 −- BCP-ALL subgroup, 54.5%, 27.3% and 18.2% of cases clustered with type 1, 2 and 3 hematogones, respectively. ResultsĪll cases of CD10 + BCP-ALL clustered with type 1 hematogones. To enable quantitative assessment of antigen expression on the different cell types, an objective scale of antigen expression was developed, the basis of which was direct fluorescence measurement using multicolor flow cytometry. The aim of the study was to enumerate the actual differences between the leukemic blasts in the CD10 + and CD10 − subgroups of BCP-ALL and hematogones by assessing the expression of the antigens: TdT, CD34, CD45, CD10, CD38, CD20 and CD22. In B-cell precursor acute lymphoblastic leukemia (BCP-ALL), the malignant counterpart of hematogones, the leukemic blasts share common phenotypic features. Currently, there are three major maturational stages of CD19 antigen expressing B-cell precursors (hematogones).
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