OBJECTIVE:

To highlight the best antibody selection strategy to characterize the presence of paroxysmal nocturnal hemoglobinuria (PNH) clones in patients undergoing diagnostic investigation of acute leukemia or in therapeutic follow-up.

MATERIALS AND METHODS:

Forty-one peripheral blood and bone marrow samples from patients with acute leukemia who underwent diagnostic investigation or therapeutic follow-up at two oncological and public hospitals in Belém, Pará State, Brazil, from February to July 2015, were analyzed.

RESULTS:

A total of 58.5% were male, 41.5% were 0-10 years old, 56.1% were under diagnostic investigation, and 43.9% were under therapeutic follow-up. Among cases under diagnostic investigation, 43.5% (10/23) were B-cell acute lymphoblastic leukemia and 26.1% (6/23) acute myeloid leukemia. The presence of PNH clones was observed in 9.8% (4/41) of cases, being 3/4 under diagnostic investigation and 1/4 under therapeutic follow-up, without relapse. The combination of FLAER/CD59PE/CD45Per-Cy5 antibodies in blasts and lymphocytes, FLAER/CD15PE/CD45Per-Cy5/CD24APC in granulocytes, and FLAER/CD14PE/CD45Per-Cy5/CD64APC in monocytes proved to be the best strategy to characterize the presence of PNH clones in these patients, regardless of sample type.

CONCLUSION:

The presence of PNH clones in patients with acute leukemia did not depend on cell ontogeny or patient stage (diagnosis or therapeutic follow-up). The best antibody strategy for the identification of PNH clones in leukemic blasts, regardless of their ontogeny, was by combining FLAER with CD45.

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