DNA Ploidy Analysis in Acute Leukemia by Flow Cytometry

Background: The detection of chromosomal abnormalities holds significant diagnostic and prognostic value in acute leukemia. While cytogenetics is the standard technique for evaluating ploidy, it is a tedious and labor-intensive process compared to flow cytometry. Flow cytometric determination of leukemic cell DNA content reflects the proliferative index of blast cells. This technique is rapid, cost-effective, sensitive, easy to perform, independent of the tumor's proliferation state, and applicable to nearly all hematological malignancies. Materials and Methods: This study was conducted to determine DNA ploidy in all acute leukemia cases using flow cytometry over a one-year period. A total of 53 new acute leukemia cases were diagnosed based on morphology, special stains, and immunophenotyping. The DNA index was then correlated with other clinico-hematological parameters. Results: In our study, the overall incidence of aneuploidy was 32.07%, with 24% being hyperdiploid and 8% hypoploid. The majority of the aneuploid cases were male (58.8%), while diploid cases showed a female preponderance. We observed that acute lymphoblastic leukemia (ALL) patients with hyperdiploidy demonstrated favorable prognostic factors (i.e., clinico-hematological parameters), whereas hypoploidy was associated with poorer prognostic factors. In acute myeloid leukemia (AML) patients, hyperdiploidy was linked to poor prognostic factors. Conclusion: We recommend that each newly diagnosed case be analyzed by flow cytometry, in addition to karyotyping, for early identification of patients who may benefit from conventional induction therapy.