Morphometric and elastic properties of immature reticulocytes in health and during acute lymphoblastic and acute myeloid leukemia

Despite significant advances, many changes occurring in the tumor microenvironment during acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) remain unclear. The surface of immature reticulocytes was examined by atomic force microscopy (AFM) to determine specific changes during the development of ALL and AML. In patients with ALL the surface area of reticulocytes increased by 18.5%, volume by 8.7%, the width of invaginations by 18%, and cell height decreased by 7.8%. In patients with AML, the volume increased by 12.6%, roughness by 35.5%, the height of protrusions by 36.2%, the depth of invaginations by 24.8%, their width by 18.2%, and the maximum height difference of the surface by 31.9%. No significant differences in Young’s modulus were found, but a downward trend was noted. The obtained data has important prognostic value in studying the bone marrow activity during acute leukemia. Highlights AFM reveals implicit signs of malignant disease development in the blood. ALL increases area, volume, and invaginations, but reduces the height of IRF. AML increases volume, roughness, protrusions, and invaginations of IRF.