The Development Of Immunophenotyping

Characterization of antigens as a means of leukemia subtyping began in the early 1980s with a limited number of polyclonal antisera that allowed a distinction between T and non-T ALL.56,57 Following the introduction of monoclonal antibody technology,58 the first such antibodies that could be widely produced and that found their way into the clinical laboratory were directed against lymphoid antigens, thereby providing an early glimpse at the tremendous immunophenotypic diversity of ALL, which had not been appreciated by conventional morphology and cytochemistry. Perhaps because the generation of antimyeloid antibodies did not proceed as rapidly as that of antilymphoid antibodies or because cytology appeared to be more informative in AML than in ALL, routine immunopheno-typing for AML is a much more recent event. A series of seven International Workshops and Conferences on Human Leukocyte Differentiation Antigens ensured that the plethora of emerging antibodies was carefully characterized in terms of specificities and tissue distribution and segregated into clusters of designation (CD).59-64 The CDw designation (w standing for workshop) is sometimes given to antibodies whose reactivity has not been completely defined or to those of which only a limited number (sometimes only one) seem to form that cluster. During the latest of these workshops held in Harrogate, England, in June 20 00,65 the number of CDs defined increased to a total of 247, now also including cluster assignments for cytokine and growth factor receptors as well as endothelial cell molecules. This latter development reflects our growing understanding that antigens, aside from being essential for the differ ential diagnosis of leukemias, may be key regulators in signaling pathways determining cell proliferation, differentiation, survival, or programmed cell death.

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