Immunophenotypic analysis of B-cell acute lymphoblastic leukemia at a tertiary care hospital in Sri Lanka

Objectives: B-cell acute lymphoblastic leukemia (B-ALL) is a hematological malignancy that predominantly affects children and is characterized by the rapid proliferation of immature lymphoblasts. This study aims to describe the immunophenotypic characteristics of B-ALL in a cohort of patients diagnosed in a tertiary care hospital in Sri Lanka. Materials and Methods: A descriptive analytical study was conducted on 47 B-ALL cases diagnosed between June 2021 and December 2024. Diagnosis was established through morphological examination and immunophenotypic analysis using multi parameter flow cytometry. Results: The cohort’s mean age was 35.1 years, with a near-equal gender distribution (51.1% female, 48.9% male). Immunophenotypic analysis by flow cytometry revealed cluster of differentiation (CD19) positivity in 97.9% of cases, CD10 in 89.4%, and CD34 in 97.9%. Aberrant myeloid markers CD13 and CD33 were present in 32% and 30% of cases, respectively. The majority (53.2%) were classified as typical B-ALL without aberrant markers. Conclusion: The study highlights significant immunophenotypic heterogeneity in B-ALL among Sri Lankan patients, with a notable adult representation. The high expression of core B-cell antigens reinforces their diagnostic utility, while the presence of aberrant myeloid markers suggests underlying genetic complexities associated with poor prognostic factors. Further research is warranted to explore genetic profiling and its implications for treatment outcomes.