The significance of differential diagnosis of monocyte lineage involved leukemia by multi-parameter flow cytometry

Objective:To differential diagnose monocyte lineage involved leukemia(MLIL) by multi-parameter flow cytometry.Methods:The expression of CD14 and other related antigens were analyzed in 179 prime patients with leukemia by CD45/SSC Dot plot gated multi-parameter flow cytometry.Results:Among 179 patients with leukemia, the expression rate of CD14 were 25.6% in acute myelocytic leukemia(AML) , 5.9% in chronic myelocytic leukemia(CML) and 100% in chronic myelomonocytic leukemia(CMML) respectively, while it was negative expression in acute lymphoblastic leukemia(ALL), chronic lymphoblastic leukemia(CLL),acute undifferentiated leukemia(AUL) and acute bipolar phenotype leukemia(BAL) .With 117 AML patients, the positive rate of CD14 were 75.0% in M4(15/20), 22.2% in M5a(2/9) and 92.9% in M5b(13/14) respectively, it was no significant difference between M4 and M5(P=0.486), but it was significant difference between M5a and M5b(P0.001); it was all negative in M0,M1,M2 ,M6 and M7 patients. In AML group, the expression of CD14 was negative correlation with CD117 and CD34,it was positive correlation with CD64,HLA-DR,CD4,CD36,CD15 and CD11b. Within the CD45/SSC,CD71/CD33 and CD15/CD11b scatter diagram, the clone site of granulocyte and monocyte were obviously different between M4 and M5.Conclusion:CD14 was high specificity and low sensitivity in diagnosing MLIL; CD14 association with other antigens could be used to distinguish not only MLIL but also M4 and M5 subtype; CD45/SSC,CD71/CD33 and CD15/CD11b Dot plot contributed to distinguish granulocyte and monocyte clone.