Identification of NPMc+ acute myeloid leukemia in bone marrow smears

Judit Bedekovics, László Rejto, Béla Telek, Attila Kiss, Zsuzsanna Hevessy, Anikó Ujfalusi, Gábor Méhes

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Abstract

The most frequent genetic change currently known in acute myeloid leukemia (AML) is the mutation of the nucleophosmin (NPM) gene. Aberrant cytoplasmic accumulation of NPM protein (NPMc+) is the result of this mutation, and it can be demonstrated by immunohistochemistry for the identification of a favorable subgroup within "AML with normal karyotype" according to the World Health Organization classification. NPM staining pattern was defined in 71 AML and 15 control cases by the use of bone marrow smears in order to overcome limitations observed due to immunohistochemistry. In 13/71 cases (18.3%), clear cytoplasmic staining of the leukemic blast cells was detectable that was comparable with the positivity of mitotic figures physiologically lacking nuclear membrane. The biological and genetic characteristics of the NPMc+ cases determined this way were identical with the previously published results including low CD34 and HLA-DR expression and lack of recurrent karyotype abnormalities. Bone marrow smears are well applicable and therefore a real alternative for the determination of NPM with the highest accuracy for optimal risk stratification in AML.

Original languageEnglish
Pages (from-to)73-78
Number of pages6
JournalApplied Immunohistochemistry and Molecular Morphology
Volume21
Issue number1
DOIs
Publication statusPublished - Jan 1 2013

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Keywords

  • NPMc+
  • acute myeloid leukemia
  • bone marrow
  • immunocytochemistry
  • nucleophosmin

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Medical Laboratory Technology

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