TITLE:
The Role of Kappa and Lambda in Subclassification of B Cell Lymphoblastic Leukemia in Sudanese Patients Using Flow Cytometry
AUTHORS:
Hameeda Abd Eladeem Abdalla, Amira Ahmed Khalid Humeida, Eman Abbass, Osama A. Altayeb, Ghada M. Marghani
KEYWORDS:
B Cell Acute Lymphoblastic Leukemia, Immunoglobulin, Kappa, Lambda, Flow Cytometer
JOURNAL NAME:
Open Journal of Blood Diseases,
Vol.6 No.3,
September
13,
2016
ABSTRACT: Background: B-cell Acute lymphoblastic leukemia (B-ALL) is a neoplasm of lymphoblasts
which are of B-cell lineage typically composed of small to medium sized
blast cells, moderately condensed to dispersed chromatin with scanty cytoplasm and
inconspicuous nucleoli, involving the bone marrow and/or blood. Methods and
materials: This is a prospective cross-sectional study in which 50 blood and/or bone
marrow samples of newly diagnosed patients (B-ALL) were tested for immunophenotyping.
All samples were prepared for surface and cytoplasmic markers including
kappa and lambda human antibody for 10 minutes in dark place and then run by the
Flow Cytometer. Results: 64% of the study populations were males and 36% were
females. Cases were classified according to immunophenotype and the age into different
subtypes and showed the following frequencies: Pro B-ALL (8%), early pre B-ALL
(56%), common B-ALL (16%), Pre-B-ALL (14%) and Mature B-ALL (only 6%). Surface
immunoglobulin was positive in 10% and negative in 90% of all patients, showing
100% positivity in mature B-ALL and totally negative in other subtypes. While
cytoplasmic immunoglobulin was positive in 16% and negative in 84% of all patients
and was positive in 100% of Pre-B-ALL and in 50% of mature B-ALL. Surface kappa
was more expressed in mature B-ALL than lambda giving a ratio of 2:1, while cytoplasmic
kappa:lambda was 6:1 in Pre-B-ALL. Conclusion: Kappa and lambda have
important role in B-ALL classification which necessitates their presence in immunophenotyping
of B-ALL.