Original Research

Flow cytometric characterisation of acute leukaemia in adolescent and adult Ethiopians

Jemal Alemu, Balako Gumi, Aster Tsegaye, Abdulaziz Sherif, Fisihatsion Tadesse, Amha Gebremedhin, Rawleigh Howe
African Journal of Laboratory Medicine | Vol 14, No 1 | a2394 | DOI: https://doi.org/10.4102/ajlm.v14i1.2394 | © 2025 Jemal Alemu, Balako Gumi, Aster Tsegaye, Abdulaziz Sherif, Fisihatsion Tadesse, Amha Gebremedhin, Rawleigh Howe | This work is licensed under CC Attribution 4.0
Submitted: 28 December 2023 | Published: 23 January 2025

About the author(s)

Jemal Alemu, Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Armauer Hansen Research Institute, Addis Ababa, Ethiopia; and Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
Balako Gumi, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
Aster Tsegaye, Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Abdulaziz Sherif, Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Fisihatsion Tadesse, Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Amha Gebremedhin, Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Rawleigh Howe, Armauer Hansen Research Institute, Addis Ababa, Ethiopia

Abstract

Background: Flow cytometric characterisation of acute leukaemia is a key diagnostic approach for clinical management of patients, but is minimally practised in resource-constrained settings like Ethiopia.

Objective: This study aimed to determine the immunophenotypes of acute leukaemia by flow cytometry at Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia.

Methods: A cross-sectional study was conducted on adolescent and adult inpatients consecutively admitted from April 2019 to June 2021. Peripheral blood samples were stained for surface and cytoplasmic markers, and analysed by four-colour flow cytometry.

Results: Of 140 cases aged 13 years to 76 years, 74 (53%) were men and 66 (47%) were women, 68 (49%) had acute lymphocytic leukaemia (ALL), 65 (46 %) had acute myelogenous leukaemia (AML), and 7 (5.0%) had acute leukaemia non-otherwise specified. Acute lymphocytic leukaemia was more common among adolescent and male cases; AML was more common among adult and female cases. Among ALL subtypes, B-cell acute lymphocytic leukaemia cases (73.5%) were more common than T-cell acute lymphocytic leukaemia (26.5%). A subset of acute leukaemia, CD19+/CD56+ AML was identified in 3 cases (6% of AML). Of the B-cell ALL cases, 21 (42%) were CD34+/CD10+/CD66c+, 10% were CD34+/CD10+/CD66c–, 32% were CD34-/CD10+, and 6% were CD34+/CD10–. An unexpectedly high number of T-cell ALL cases that lacked surface CD3 were observed to have significantly higher levels of aberrantly expressed myeloid markers.

Conclusion: We observed multiple phenotypes identifying subtypes of acute leukaemia cases, extending our previous studies in Ethiopia.

What this study adds: This study extends previous studies by describing phenotypically defined subsets of ALL and AML which, in addition to diagnosis, may have useful prognostic value for clinicians.


Keywords

flow cytometry; acute leukaemia; Ethiopia; phenotype; cell surface biomarker; cytoplasmic biomarker

Sustainable Development Goal

Goal 3: Good health and well-being

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