Comparison of Bone Marrow Aspiration Interpretation with Immunophenotyping in Children’s Leukemia Diagnosis

BACKGROUND: The prevalence of cancer in children is increasing. The morphological diagnosis of acute leukemia is divided into acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) and is sometimes incompatible with the diagnosis of flow cytometry, which shows the characteristics of malignant cells.
AIM: This study aims to compare the results of the interpretation of bone marrow aspiration with immunophenotyping in diagnosing childhood leukemia.
METHODS: Data from medical records were used in a retrospective cohort study of children with leukemia (ages 1–18 years) admitted to Dr. Wahidin Sudirohusodo Hospital Makassar from 2013 to 2017. All patients with a working diagnosis of leukemia were examined for bone marrow aspiration, followed by immunophenotyping, and each group was analyzed.
RESULTS: Of a total of 90 study subjects, the final diagnosis based on immunophenotyping was 60 ALL and 30 AML patients with a mean age of 8 years and 3 months. The male-to-female ratio was 1.7:1 (p = 0.353). The mean age of the ALL group was 7 years and 10 months, and AML, 9 years (p = 0.409). The suitability of morphology and flow cytometry to ALL and AML was 92.3% and 50%, respectively. Most markers were in the ALL CD 10 groups and CD 20 groups with a sensitivity of 100% each, and AML CD 117 with a sensitivity of 92%.
CONCLUSION: There was a correlation between the interpretation of bone marrow aspiration and immunophenotyping in diagnosing ALL.