B-ALL gating strategy

B-ALL gating strategy
Author: Girish Venkataraman, MD, MBBS
Category: Myeloid Neoplasms and acute leukemia (WHO 2016) > Precursor Lymphoid Neoplasms > B-lymphoblastic leukemia/lymphoma
Published Date: 09/07/2017

  1. Top left panel shows a large red cluster which is CD45 negative (relative to the moderate lymphocytes in purple). On the CD19 plot to the right, this cluster has relatively dimmer CD19 compared to the CD45 bright B-lymphoid cels (gated on top right). Only events within the CD19+ blast gate is depicted in the three bottom plots.
  2. In the bottom left plot, the red blast cluster is negative for CD20 with partial dim CD10, The middle plot shows uniform CD34 expression, while the right extreme plot shows the blasts to express CD33 and bright CD58. CD58 is often positive in neoplastic B-lymphoblasts and the dim-negative CD38 and positive CD58 are both abnormal features that help distinguish from hematogones in difficult cases. Expression of CD33 is also an aberrant feature commonly observed in B-ALLs and does not connote myeloid lineage.