Просмотр полной версии : экспрессия CD10+

Уважаемые коллеги, очень интересный случай.
У ребенка с диагнозом ОЛЛ common вариант на 36 день терапии при общем количестве бластов 0,6%, при фенотипировании было выявлено экспрессия CD10+ в миелоидном гейте 65%, коэкспрессия с CD33+ CD10+ 45%. Можете подсказать как интерпритировать данные результаты, можно-ли считать это минимальной резидуальной болезнью, где можно найти литературу на данную тему. Заранее спасибо

Не специалист, но наличие этих 2 маркеров может указывать на наличие B-cell precursor-leukemia cell:

As suggested in the EGIL classification, the B-I pro-B cell line is CD10−, while B-II common-B and B-III pre-B cell lines are CD10+; the latter subgroup also shows cytoplasmic IgM (cyIgM). All three categories are surface membrane Ig (smIg)-negative...Of particular interest is detection of the two surface antigens CD13 and CD33 which are commonly regarded as being associated with the myelomonocytic lineages (see below): CD13+13/27 and CD33+5/27, particularly in groups B-I and B-II. Thus, some BCP-cell lines have ‘biphenotypic’ surface marker expression; nevertheless, other criteria clearly assign them to the B cell lineage (e.g. cyCD22, IGH rearrangement, etc.).

Из Leuk Res. 1998 Jul;22(7):567-79.
Establishment and characterization of human B cell precursor-leukemia cell lines.
Matsuo Y, Drexler HG.

Описание одного случая с похожим фенотипом (фрагментарно):

In contrast to the vast majority of normal lymphoblasts, a significant proportion of acute lymphoblastic leukaemias (ALLs) co-express myeloid antigens, such as CD13, CD14, CD15, CD33, CD65 and/or CD66c at diagnosis (Drexler et al, 1991; Wiersma et al, 1991; Sugita et al, 1999). Also, several acute myeloid leukaemias (AMLs) co-express lymphoid antigens such as CD2, CD4, CD7 and CD19 (Drexler et al, 1993; Reading et al, 1993). Rarely, acute leukaemias co-express several antigens from two differentiation lineages; if so, the diagnosis of acute biphenotypic leukaemia is assumed (Carbonell et al, 1996).

Interlineage switch of acute leukaemia at relapse usually concerns a switch from ALL to AML and has been reported to occur in 5–7% of cases (Stass et al, 1984; Van Wering et al, 1995). Such phenotype switches generally occur late in the course of the disease and are most frequently assumed to represent therapy-induced secondary malignancies. However, in rare cases, analyses of immunoglobulin (Ig) and T-cell receptor (TCR) gene rearrangements have suggested that both malignancies were derived from the same stem cell clone (Beishuizen et al, 1994a). In contrast, an early lineage switch during induction chemotherapy is an extremely rare event. Such an early phenotypic switch might be the result of aberrant differentiation of the malignant clonogenic cells or selection of a minor subfraction from a mixed population as the result of selective killing by chemotherapy.

...Cytomorphology and immunophenotyping at diagnosis showed an ALL with a CD10-positive precursor B-ALL phenotype with co-expression of two myeloid markers (CD33 and CD13dim). Two weeks later, an acute leukaemia of monocytic cell type could be seen with α-naphthyl-acetate-esterase positivity inhibited by sodium fluoride; this was supported by positivity for CD13 (dim), CD14 and CD33, but negativity for TdT and the B-cell markers CD10, CD22 and CD79a; only CD19 was expressed. At relapse, the morphology was undifferentiated and the original CD10-positive precursor B-ALL phenotype had reappeared again...

Из Br J Haematol. 2001 Jun;113(3):757-62.
Two consecutive immunophenotypic switches in a child with immunogenotypically stable acute leukaemia.

большое спасибо за коментарий, обязательно посмотрю указанные статьи.

Вообще при 0,6% врядли можно получить достоверные результаты иммунофенотипирования, MRD методом иммунофенотипирования на проточниках для ОЛЛ весьма не достоверно