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. 2014 Aug 15;7(9):6225-30.
eCollection 2014.

Expression of CD25 is a specific and relatively sensitive marker for the Philadelphia chromosome (BCR-ABL1) translocation in pediatric B acute lymphoblastic leukemia

Amos S Gaikwad  1 , Rachel E Donohue  2 , M Tarek Elghetany  3 , Andrea M Sheehan  3 , Xinyan Y Lu  4 , Maria M Gramatges  1 , Kenneth L McClain  1 , Toni-Ann Mistretta  3 , Jyotinder N Punia  3 , Timothy J Moore  5 , Tatiana Goltsova  5 , Michael Cubbage  5 , Choladda V Curry  3
Affiliations

Expression of CD25 is a specific and relatively sensitive marker for the Philadelphia chromosome (BCR-ABL1) translocation in pediatric B acute lymphoblastic leukemia

Amos S Gaikwad et al. Int J Clin Exp Pathol. .

Abstract

Background: Precursor B acute lymphoblastic leukemia (B-ALL) is the most common cancer in children and overall, has an excellent prognosis. However, the Philadelphia chromosome translocation (Ph+), t(9;22)(q34;q11), is present in a small subset of patients and confers poor outcomes. CD25 (IL-2 receptor alpha chain) expression has been associated with Ph+ B-ALL in adults, but no similar study has been performed in pediatric B-ALL.

Methods: A retrospective analysis of 221 consecutive pediatric patients with a diagnosis of B-ALL (blood and/or bone marrow) from 2009 to 2012 was performed to determine an association between Ph+ B-ALL and CD25 expression. A threshold of 25% was used to define positive cases for CD25 expression by flow cytometry.

Results: There were 221 patients with a diagnosis of B-ALL ranging from 2 to 22 years (median, 6 years). Eight (3.6%) B-ALL patients were positive for the Philadelphia chromosome translocation (Ph+ B-ALL) and 213 were negative (Ph-negative B-ALL). CD25 expression was observed in 6 of 8 (75%) Ph+ B-ALL patients and 6 of 213 (2.8%) Ph-negative B-ALL patients. CD25 expression was significantly higher in Ph+ B-ALL compared to Ph-negative B-ALL, with median CD25 expression of 64% (range 0-93%) and 0.1% (range 0-91%), respectively (P ≤ 0.0002). Therefore, CD25 expression as a predictor of Ph+ B-ALL had 75% sensitivity, 97% specificity, 50% positive predictive value and 99% negative predictive value.

Conclusions: CD25 expression is a specific and relatively sensitive marker for the identification of Ph+ B-ALL in the pediatric population.

Keywords: B acute lymphoblastic leukemia; B-ALL; BCR-ABL; CD25; Ph+; Ph+ B-ALL; Philadelphia chromosome; flow cytometry; pediatric; t(9;22).

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Figures

Figure 1
Figure 1
Representative plots used in CD25 analysis. A, B: Gating strategy for CD25 analysis. A: Normal lymphocytes (P2) were gated on a CD45 vs side scatter dot plot. B: Normal lymphocytes (P2) from plot A show a sub-population (in blue) that expresses CD25. This quadrant is used to identify the percentage of gated blasts that express CD25. C, D: Representative example of positive CD25 expression in B-ALL (Ph-negative). C: Gated lymphoblasts (P2) shown on a CD10 vs. CD19 plot. D: 90% of the gated lymphoblasts express CD25, which is considered positive. E, F: Representative example of negative CD25 expression in B-ALL (Ph-negative). E: Gated lymphoblasts (P2) on CD10 vs CD19 plot. F: 0.7% of gated lymphoblasts express CD25, which is considered negative.
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