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Am J Clin Pathol. 2017 Apr 1;147(4):374-381. doi: 10.1093/ajcp/aqx021.

Clinical Significance of Isolated Myeloperoxidase Expression in Pediatric B-Lymphoblastic Leukemia.

Author information

1
Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Blvd., Los Angeles, CA
2
Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles.
3
Zhejiang University School of Medicine, Children's Hospital, Hangzhou, China.
4
Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
5
Children's Center for Cancer and Blood Diseases Biostatistics Core, Children's Hospital Los Angeles, Los Angeles, CA.

Erratum in

Abstract

Objectives:

Diagnosis of B-cell acute lymphoblastic leukemia (B-ALL) requires immunophenotypic evidence of B-lineage and absence of specific myeloid or T-lineage markers. Rare cases of otherwise typical B-ALL express myeloperoxidase (MPO) detectable by flow cytometry with an absence of other myeloid markers, but the clinical significance of this finding is not well studied.

Methods:

A retrospective cohort analysis of flow cytometry and clinical data was performed to investigate the clinical outcome of this specific group of patients.

Results:

Twenty-nine cases of otherwise typical B-ALL that expressed MPO by flow cytometry (B-ALL-isoMPO) without expression of other myeloid markers were identified. The B-ALL-isoMPO group had a significantly increased incidence of relapse (univariate log rank P  = .0083; multivariate hazard ratio, 2.50; 95% confidence interval, 1.07-5.85; P  = .034) and significantly worse event-free survival by univariate analysis (log rank P  = .0066) compared with a reference group of patients with B-ALL from the same time period (n = 264).

Conclusions:

To our knowledge, this is the first report to document the clinical outcomes in a group of pediatric patients with B-ALL that expresses MPO in the absence of other myeloid markers. This group had an increased rate of relapse and a worse event-free survival than the patients with B-ALL who did not express MPO.

KEYWORDS:

B-ALL; Mixed-phenotype acute leukemia; Myeloperoxidase

PMID:
28340210
DOI:
10.1093/ajcp/aqx021
[Indexed for MEDLINE]

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