What are the immunophenotypic features of acute myeloid leukemia (AML) with myelodysplasia-related changes (AML-MRC)?

Updated: Feb 25, 2018
  • Author: Angie Duong, MD; Chief Editor: Christine G Roth, MD  more...
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Answer

Answer

By flow cytometry, the blasts in acute myeloid leukemia (AML) with myelodysplasia-related changes (AML-MRC) show a myeloblast phenotype, with expression of blast markers (CD34, CD117) as well as myeloid markers such as CD13, CD33, MPO; aberrant expression of CD5, CD7, or CD56 may also be seen. The background granulocytes may also aberrantly overexpress CD33 and underexpress CD45, CD11b, and CD15 by flow cytometry. Similarly, lower expression levels of CD14, CD56, and CD45 may be seen on background monocytic populations in AML-MRC. [14]

Immunohistochemical staining of the bone marrow biopsy specimen may be especially helpful in cases with increased fibrosis and an inadequate aspirate specimen. In AML-MRC, CD34 and/or CD117 immunostains reveal numerous (>20%) blasts which often form large clusters and sheets. In cases emerging from a preexisting myelodysplastic syndrome (MDS), these stains may also highlight increased blasts located away from the bony trabeculae (atypical localization of immature precursors [ALIP]).


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