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Tumor Discovery Immunophenotypic patterns of childhood acute leukemia

18.3% (Cortical-T -ALL 27.9%, Pro-T- ALL 8.2%, early 5. Conclusion
thymic -T- ALL 9.8%, and medullary-T- ALL 24.6%), AML
comprising 32.1% with recurrent cytogenetic abnormalities The immunophenotypic pattern in Delhi-NCR shows
(11.9% t [8;21], 12.3% t [15;17] that is acute promylocytic B-ALL (51.5%) as the most prevalent, followed by AML
leukemia, 2.9% with inversion 16/t [16;16], 3.9% MLL gene (22%), MPAL (16.3%), and T-ALL (10.2%). Based on
rearrangement, and 1.1% with 3q abnormalities), and 2.3% immunophenotype, the most common childhood AL is
B-ALL (Common-B-ALL), in contrast to South India, where
MPAL. 18
T-ALL predominates. However, the mortality rate is highest
Different studies from North India have reported. in AML in comparison to other AL subtypes. Among B-ALL
The aberrant phenotypes with myeloid antigens at 42.5% cases, Common-B-ALL demonstrates the most favorable
and 11% were reported by in ALL cases different studies prognosis, consistent with findings in global literature.
from North India in ALL cases. 14,16 These findings were
different from our study results; we found an overall The different immunophenotypic patterns observed
aberrant antigen expression of 16.2%, and with myeloid between Delhi-DCR and South India suggest the presence
antigen expressed most predominantly in 90.8% in of of underlying factors, warranting further investigation.
Additional studies are required to elucidate the reasons
B-ALL (My+B-ALL, 10/11 cases). We found one case behind these differences. Enhanced understanding of
(9.1%) expressing aberrant lymphoid antigen in AML immunophenotypic patterns and their prognostic value
(Ly+AML). Other studies have found, which reported within specific geographical areas will not only facilitate
the most common aberrant expressing antigen CD13 improved patient management but also aid in the
as the most commonly aberrantly expressed antigen (at formulation of health-care policies.
32.2% and 25.6%, respectively). 14,18 Whereas in our study,
we found observed mostly a predominance of 14.7% of Acknowledgments
aberrant expression of myeloid antigens CD13 (70%),
CD33 (50%), and both (20% common) aberrant expressing None.
the myeloid antigen. Sharma et al. found 2.99% MPAL, Funding
14
out of them, which only seven pediatric patients showed
aberrant lymphoid antigen expression in AML. The None.
14
overall configuration of the immunophenotypic pattern
of childhood AL has changed from the maximum Conflict of interest
proportion that majority of AL cases were being B-ALL The authors declare no conflicts of interest.
to a significant portion of non-B-ALL (T-ALL, AML, and
MPAL) (constituting approximately 40 – 45%) of cases in Author contributions
the worldwide and in India. In our study, we found that Conceptualization: Anju Khairwa
48% of AL cases were non-B -ALL proportions of AL, Formal analysis: Anju Khairwa
which affects the prognosis of AL. Investigation: Pooja Dewan, Swati Jain
The present study evaluated the prognostic significance Methodology: Anju Khairwa
of different immunophenotypes of in AL. We found Writing – original draft: Anju Khairwa
the maximum highest mortality rate of 86.7% in AML, Writing – review & editing: Mrinalini Kotru
followed by 57.2% in T-ALL 57.2% and 45.5% in MPAL.
B-ALL (subtype-: Common -B -ALL) showed the best Ethics approval and consent to participate
most favorable prognosis (with a minimum mortality rate The University College of Medical Sciences ethics
of 40%). Similarly, the world literature worldwide reported committee approved the study protocol with the number
a favourable prognosis associated with B-ALL and a poor (IECHR-2021-51-15R1). The study was conducted in
prognosis related to AML and T-ALL. A study by Santos et accordance with the ethical guidelines of the college. This
19
al. provided the relavance of immunophenotypic markers retrospective cross-sectional study was performed at a
20
as independent prognostic factors that could be included tertiary care institute in Delhi, India. Informed consent
integrated into clinical protocols, for risk stratification and was not applicable as the study was retrospective, and there
therapeutic guidance. 20 was no direct contact with patients. Data were retrieved
The limitations of our study were included: (i) the sample from the departmental archive.
size was a small, (ii) The lack of further confirmation by Consent for publication
molecular techniques and (iii) we were unable to correlate
with cytogenetic findings of AL. This retrospective cross-sectional study was performed at

Volume 3 Issue 2 (2024) 7 doi: 10.36922/td.2545