Immunophenotyping panel for diagnosis of AML and mixed phenotype AML in children
| Diagnosis of AML* | |
| Precursor stage | CD34, CD117, CD133, HLA-DR |
| Myelomonocytic markers | CD4, CD11b, CD11c, CD13, CD14, CD15, CD33, CD36, CD64, CD65, CD184 (CXCR4), intracellular† myeloperoxidase (iMPO), i-lysozyme |
| Megakaryocytic markers | CD41, CD42, CD61 |
| Erythroid marker | CD235a |
| Leukemia specific antigen | NG2 homolog‡ |
| Lineage aberrant antigens | CD2, CD7, CD19, CD56 |
| Pan-leukocyte markers | CD11a, CD45 |
| Diagnosis of MPAL§ | |
| Myeloid lineage | iMPO or evidence of monocytic differentiation by at least two of i-lysozyme, CD11c, CD14, CD64 |
| B-lineage | CD19 (strong) with at least 1 of iCD79a, iCD22, CD10; or CD19 (weak) with at least 2 of iCD79a, iCD22, CD10 |
| T-lineage | iCD3 or surface CD3 |
| Diagnosis of AML* | |
| Precursor stage | CD34, CD117, CD133, HLA-DR |
| Myelomonocytic markers | CD4, CD11b, CD11c, CD13, CD14, CD15, CD33, CD36, CD64, CD65, CD184 (CXCR4), intracellular† myeloperoxidase (iMPO), i-lysozyme |
| Megakaryocytic markers | CD41, CD42, CD61 |
| Erythroid marker | CD235a |
| Leukemia specific antigen | NG2 homolog‡ |
| Lineage aberrant antigens | CD2, CD7, CD19, CD56 |
| Pan-leukocyte markers | CD11a, CD45 |
| Diagnosis of MPAL§ | |
| Myeloid lineage | iMPO or evidence of monocytic differentiation by at least two of i-lysozyme, CD11c, CD14, CD64 |
| B-lineage | CD19 (strong) with at least 1 of iCD79a, iCD22, CD10; or CD19 (weak) with at least 2 of iCD79a, iCD22, CD10 |
| T-lineage | iCD3 or surface CD3 |
The table provides a list of selected markers (bold type represents the mandatory minimal panel required to fulfill WHO and EGIL criteria3,6 ), differing from the adult panel reported by Döhner et al4,214 in only a few markers (italics), which may have diagnostic or therapeutic implications.
Intracellular expression is represented by prefix “i.”
Most cases with rearranged MLL gene express the NG2 homolog reacting with the monoclonal antibody 7.1.
The requirements for assigning MPAL are based on the WHO 2008 criteria.3 Note that MPAL can also be diagnosed if there are 2 or more blast populations from different lineages.