Presença de clones de hemoglobinúria paroxística noturna em portadores de leucemia aguda do estado do Pará, Amazônia, Brasil

Lacy Cardoso de Brito; Fábio Rodrigues de tOliveira; Debora Alves Cardoso; Bruno Marcel Silva de Melo; Murilo Chermont Azevedo; Matheus Holanda Nascimento; Debora Monteiro Carneiro; Ana Paula Silveira Paixão

doi:10.5123/S2176-6223201900021

Authors

Lacy Cardoso de Brito, Júnior Universidade Federal do Pará, Instituto de Ciências Biológicas, Laboratório de Patologia Geral, Imunopatologia e Citologia, Belém, Pará, Brasil http://orcid.org/0000-0001-9102-5817
Fábio Rodrigues de tOliveira Universidade Federal do Pará, Instituto de Ciências da Saúde, Curso de Especialização em Hematologia e Imunologia, Belém, Pará, Brasil; Universidade Federal do Amapá, Departamento de Ciências Biológicas e da Saúde, Laboratório de Controle de Qualidade e Bromatologia, Macapá, Amapá, Brasil http://orcid.org/0000-0003-2761-3440
Debora Alves Cardoso Universidade Federal do Pará, Instituto de Ciências da Saúde, Curso de Especialização em Hematologia e Imunologia, Belém, Pará, Brasil http://orcid.org/0000-0003-1437-9106
Bruno Marcel Silva de Melo Universidade Federal do Pará, Instituto de Ciências da Saúde, Curso de Especialização em Hematologia e Imunologia, Belém, Pará, Brasil; Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Laboratório de Inflamação e Dor, Ribeirão Preto, São Paulo, Brasil http://orcid.org/0000-0001-7422-1445
Murilo Chermont Azevedo Universidade Federal do Pará, Instituto de Ciências da Saúde, Faculdade de Medicina, Belém, Pará, Brasil; Laboratório de Patologia Clínica Dr. Paulo C. Azevedo, Belém, Pará, Brasil
Matheus Holanda Nascimento Laboratório de Patologia Clínica Dr. Paulo C. Azevedo, Belém, Pará, Brasil
Debora Monteiro Carneiro Laboratório de Patologia Clínica Dr. Paulo C. Azevedo, Belém, Pará, Brasil http://orcid.org/0000-0003-2199-4246
Ana Paula Silveira Paixão Laboratório de Patologia Clínica Dr. Paulo C. Azevedo, Belém, Pará, Brasil http://orcid.org/0000-0003-3827-507X

DOI:

https://doi.org/10.5123/S2176-6223201900021

Keywords:

Paroxysmal Hemoglobinuria, Leukemia, Flow Cytometry

Abstract

OBJECTIVE:

To highlight the best antibody selection strategy to characterize the presence of paroxysmal nocturnal hemoglobinuria (PNH) clones in patients undergoing diagnostic investigation of acute leukemia or in therapeutic follow-up.

MATERIALS AND METHODS:

Forty-one peripheral blood and bone marrow samples from patients with acute leukemia who underwent diagnostic investigation or therapeutic follow-up at two oncological and public hospitals in Belém, Pará State, Brazil, from February to July 2015, were analyzed.

RESULTS:

A total of 58.5% were male, 41.5% were 0-10 years old, 56.1% were under diagnostic investigation, and 43.9% were under therapeutic follow-up. Among cases under diagnostic investigation, 43.5% (10/23) were B-cell acute lymphoblastic leukemia and 26.1% (6/23) acute myeloid leukemia. The presence of PNH clones was observed in 9.8% (4/41) of cases, being 3/4 under diagnostic investigation and 1/4 under therapeutic follow-up, without relapse. The combination of FLAER/CD59PE/CD45Per-Cy5 antibodies in blasts and lymphocytes, FLAER/CD15PE/CD45Per-Cy5/CD24APC in granulocytes, and FLAER/CD14PE/CD45Per-Cy5/CD64APC in monocytes proved to be the best strategy to characterize the presence of PNH clones in these patients, regardless of sample type.

CONCLUSION:

The presence of PNH clones in patients with acute leukemia did not depend on cell ontogeny or patient stage (diagnosis or therapeutic follow-up). The best antibody strategy for the identification of PNH clones in leukemic blasts, regardless of their ontogeny, was by combining FLAER with CD45.