Light Scatter	CD45/14

DR/CD34	CD11b/Glyco	CD13/15

CD33/TdT	MPO	CD3/CD7

Other markers performed which were negative; B cells (CD19, CD20, Kappa, Lambda), and CD10(Calla)

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Explaination and interpretation of Flow cytometry results
Explaination of other results seen (histology, hematology,etc) and facts about this patient's disease

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• The light scatter revealed that there were intermediate to large sized cells by forward angle light scatter which have low to intermediate granularity (internal complexity) by 90 degree light scatter (see light scatter). This matches that seen by histology (see histology).

 
• The CD45/14 contour plot reveals that the majority of cells within the large cell light scatter gates are CD45 positive but CD14 negative (54%). However, there is a significant population (43%) which does express both CD14 and CD45. These results indicates a heterogenous population with a large percentage expressing the monocyte/promonocyte antigen (LPS receptor). Combined with the light scatter this suggests an M4 AML (see CD45/14).

 
• The DR/CD34 contour plot reveals that a large percentage of cells express DR (46%), however, CD34 (hemopoietic progenitor cell antigen) is not expressed. AML-M4 usually express CD34. (see DR/CD34).

 
• The CD11b/Glycophorin contour demonstrates that there are few if any red cell precursors and that the majority of cells express CD11b (C3bi receptor) which is found on monocytes, granulocytes, and NK cells. (see CD11b/Glyco).

 
• The CD13/CD15 contour plot shows that the cells in question are heterogenous as the majority of cells express only CD15 (55%) while the rest do not.  CD13 is not expressed.  This again is unusual as most AMLs M1 - M6 express both CD13 and CD15. (see CD13/CD15).

 
• The CD33/TdT confirms the myeloid nature (CD33 positive) of these cells. It should be noted that low intensity TdT is also expressed on these cells. This low intensity expression is common in many AMLs and should not be considered a biphenotypic AML. (see CD33/TdT).

• The  Myeloperoxidase (MPO) (see MPO) positivity by flow cytometry confirms the MPO by special histology stains. The MPO apears to have some very intense expression and normal expression.

 
• All of these results when taken together suggest that this is an AML mostly likely an M4.  The percentage of CD14 is what is expected for M4.  The distinction between M4 and M5 by flow cytometry is difficult and has not traditionally been done. See AML chart below.

Explaination of other results seen (histology, hematology,etc) and facts about this patient's disease