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Analytical Cellular Pathology
Volume 17, Issue 3, Pages 145-156

Flow Cytometric DNA Index and Karyotype in Childhood Lymphoblastic Leukemia

Erik Forestier,1 Gösta Holmgren,2 and Göran Roos3

1Department of Pediatrics, Umeå University, Sweden
2Department of Clinical Genetics, Umeå University, Sweden
3Department of Pathology, Umeå University, Sweden

Received 27 February 1998; Accepted 15 October 1998

Copyright © 1998 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Flow cytometric DNA-index (DIFCM) and karyotype were analysed in 82 consecutive children with acute lymphoblastic leukemia (ALL) during a 10 year period. A statistically significant correlation existed between modal chromosome number and DIFCM (p = 0.009). DIFCM could reliably identify leukemias with >51 chromosomes, whereas only three out of 12 cases with modal chromosome numbers between 47–51 were classified as aneuploid by DIFCM. In the pseudodiploid group only one out of 20 leukemias had a DIFCM>1.0. Five leukemias with a diploid karyotype showed an aneuploid DIFCM and in three patients the flow cytometric measurement revealed biclonality undetected by karyotyping. During treatment aneuploid clones could be detected by DIFCM in a substantial number of cases where the cytogenetic analysis was normal, and the opposite was also demonstrated in one case. DIFCM gave prognostic information, showing that cases with a DI >1.12 (corresponding to 51 chromosomes) had a superior outcome with treatment protocols today in use.