CD33 expression on natural killer cells is a potential confounder for residual disease detection in acute myeloid leukemia by flow cytometry

Detection of minimal/measurable residual disease (MRD) in acute myeloid leukemia (AML) is important for guiding patient‐specific clinical management. Natural killer (NK) cells can express various markers not typically associated with NK lineage, potentially confounding the detection of MRD by flow c...

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Bibliographic Details
Published in:Cytometry. Part B, Clinical cytometry Clinical cytometry, 2020-03, Vol.98 (2), p.174-178
Main Authors: Eckel, Ashley M., Cherian, Sindhu, Miller, Valerie, Soma, Lorinda
Format: Article
Language:English
Subjects:
Acute myeloid leukemia
AML
Antigens
Bone marrow
CD16 antigen
CD33
CD56 antigen
Disease detection
Evaluation
Flow cytometry
Fluorescence
Leukemia
Leukocytes
Lymphocytes
measurable residual disease
minimal residual disease
Monocytes
Myeloid leukemia
Natural killer cells
Neoplasms
Peripheral blood
Phenotypes
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Summary:Detection of minimal/measurable residual disease (MRD) in acute myeloid leukemia (AML) is important for guiding patient‐specific clinical management. Natural killer (NK) cells can express various markers not typically associated with NK lineage, potentially confounding the detection of MRD by flow cytometry. We have observed CD33 expression on NK cells when evaluating for AML MRD in routine clinical practice in multiple patient samples. To characterize CD33 expression on NK cells, 40 peripheral blood or bone marrow samples with NK cells present at >5% of lymphocytes were selected for further assessment of NK cell phenotype and CD33 expression. Seven of the 40 samples (17.5%) were found to have CD33 expression on at least 5% of the NK cells. The CD33‐positive NK cell population accounted for an average of 11.4% of NK cells (median 11.9%, range 8.0–15.3%) and 2.2% of total white cells (median 1.1%, range 0.1‐10.1%). This NK cell subset expressed bright CD2, bright CD56, and dim CD16. On average, CD33 expression on NK cells was dimmer than on monocytes (mean median fluorescence intensity ratio 0.4; range 0.1‐1.0). This study characterizes expression of CD33 on NK cells. Recognition of this pattern of antigen expression is critical in evaluating samples for MRD in patients with myeloid neoplasms, particularly AML.
ISSN:1552-4949
1552-4957
DOI:10.1002/cyto.b.21846