Acute Leukemia Panel is a laboratory panel used in the evaluation of patients with suspected acute leukemia. The panel helps identify blast cells and determine their hematopoietic lineage, contributing to the differentiation between:
The diagnosis of acute leukemia usually requires a combination of morphology, immunophenotyping, cytogenetics, and molecular testing, depending on the clinical case.
What does the Acute Leukemia Panel analyze? The panel focuses on the immunophenotyping of hematopoietic cells, usually through flow cytometry. It analyzes the presence or absence of specific markers on the surface of or inside the cells. These markers help determine: Is there a blast cell population? Which lineage does it belong to? Is it myeloid or lymphoid? If lymphoid, is it B-cell or T-cell? Is there a mixed phenotype? Flow cytometry is an important component of the diagnostic work-up for acute leukemias.
What is flow cytometry? Flow cytometry is a laboratory method that analyzes the characteristics of thousands of individual cells within a very short period of time. The cells are exposed to antibodies conjugated to fluorochromes, which recognize specific markers. This allows the identification of different cellular profiles and determination of the immunophenotype. In acute leukemias, this helps differentiate: AML → myeloid lineage B-ALL → B-cell lymphoid lineage T-ALL → T-cell lymphoid lineage MPAL → characteristics of more than one lineage
Markers that may be included The exact marker panel may vary depending on the laboratory, the material being analyzed, and the clinical suspicion. Markers included in the Acute Leukemia Panel: CD45/14/64, CD5/CD10/CD19, CD103/CD22/CD20, CD2/CD7, CD4/CD8/CD3, HLA-DR/CD13, CD3/CD16+CD56, CD33/CD1a/CD11b, CD45/GlyA, CD61/CD41a/CD42b, CD15/CD34, IgM, CD117/CD36, MPO/Anti-TdT, CD79a/cCD3/cCD22.
What sample is used? Depending on the clinical situation, the Acute Leukemia Panel may be performed using: Peripheral blood
It is an immunophenotypic panel, usually based on flow cytometry, that helps identify and classify acute leukemias.
The panel should help differentiate AML, B-ALL, T-ALL, and acute leukemias with mixed phenotype, based on the characteristics of the sample.
It can be performed using peripheral blood or a bone marrow aspirate, depending on the clinical situation.
It can be performed using peripheral blood, but in many cases a bone marrow sample is necessary for a more complete evaluation.
It is a method that analyzes markers on individual cells and determines their immunophenotypic profile.
Yes. Immunophenotyping is a key component in determining the lineage of leukemia, but the results must be integrated with morphology, cytogenetics, and molecular testing.
Not necessarily. The Acute Leukemia Panel is primarily an immunophenotypic test. Molecular testing, FISH, or cytogenetic analysis may be required to detect specific mutations and gene fusions.
Flow cytometry may help identify a phenotype suggestive of APL, but specific testing for PML::RARA is required for molecular confirmation. APL is considered a hematological emergency.
Yes. Flow cytometry may be used to assess MRD when an appropriate immunophenotype is available for monitoring.
No. A complete diagnosis of acute leukemia requires the integration of clinical, morphological, immunophenotypic, and genetic findings.
Yes. Depending on the clinical suspicion and phenotype, BCR::ABL1 may be one of the additional molecular tests required during the work-up of acute leukemia.
Acute leukemias can progress rapidly, and some subtypes require urgent treatment. Accurate identification of the subtype and molecular alterations helps determine the appropriate therapeutic strategy.
