Morphological and Immunophenotyping Profile of Acute Leukemia: A Study from a Tertiary Level Hospital in Nepal

Abstract

Introduction: Acute leukemia is a heterogeneous disorder necessitating a multidisciplinary diagnostic approach. Flow cytometry is essential for lineage assignment and maturation stage identification. This study aims to determine the frequency and immunophenotyping of acute leukemia at Tribhuvan University Teaching Hospital (TUTH).

Methods: Conducted from January 2020, to December 2021, this cross-sectional study analyzed 504 bone marrow aspiration samples. Among these, 97 (19.2%) cases were identified as acute leukemia. Patient demographics, morphology, and immunophenotyping features were recorded and analyzed.

Results: Of the acute leukemia cases, 66% were male and 34% female. The pediatric population comprised 62.9%, while adults made up 37.1%. Cytochemical staining was performed in 92 cases, revealing 67% as acute lymphoblastic leukemia (ALL) and 33% as acute myeloid leukemia (AML). Flow cytometry was conducted on 84 cases, leading to diagnoses of 30 AML, 45 B-ALL, and 9 T-ALL.

Conclusion: Acute leukemia can affect all age groups with male preponderance. ALL is more prevalent in children, while AML is more common in adults. Immunophenotyping is critical for the classification and subtyping of acute leukemia, enhancing diagnostic accuracy and guiding treatment strategies.