Blood Res.  2023 Jun;58(2):120-123. 10.5045/br.2023.2023084.

An alternative approach to confirm mixed lineage involvement in acute leukemia with KMT2A rearrangement– an illustrative report

• Ray D
• Sreedharanunni S
• Balakrishnan A
• Sharma P
• Mallik N
• Peyam S
• Sachdeva MUS

• KMID: 2543955
• DOI: http://doi.org/10.5045/br.2023.2023084

Figure

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  Fig. 1 (A) Peripheral blood smear showing leucocytosis (May-Grünwald-Giemsa stain, ×200). (B) A peri-pheral blood smear showing leukemic blasts (black arrow) and mono-cytosis (blue arrow) (May-Grünwald-Giemsa stain, ×1,000). (C) Fluore-scent in situ hybridization from CD19 negative immune-sorted population reveals KMT2A re-arrangement based on the XL LSI KMT2A dual-color break-apart probe in 90% of cells. (D) Fluorescent in situ hybridization of CD19 positive immune-sorted population revealed KMT2A rearrangement using the XL LSI KMT2A dual-color break-apart probe in 90% of cells.

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  Fig. 2 Immunophenotyping by flow cytometry; 45% progenitor cells (blue color coded) show positivity for CD19, CD38, cytoplasmic CD79a, and HLA-DR. They are negative for CD10, CD20, CD34, CD22, myeloid, and T cell markers (not shown), confirming B-lineage leukemic blasts. Nearly 40% of the cells (magenta color-coded) were observed in the monocyte window of the CD45 versus the side scatter plot. These cells showed moderate CD45 expression and dim-to-moderate-sided scatter. These cells were positive for CD14, CD33, CD36, CD64, CD86, HLA-DR, CD7 (dim), and CD56 (subset) but negative for CD34, B cells, and other T cell markers (not shown).

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