THE ROLE OF CD38, CD23, CD200 AND CD43 EXPRESSION IN DISCRIMINATION OF CHRONIC LYMPHOCYTIC LEUKEMIA AND MANTLE CELL LYMPHOMA
(Abstract release date: 05/19/16)
EHA Library. Avcı D. 06/09/16; 134671; PB1771
Dr. Duygu Avcı
Contributions
Contributions
Abstract
Abstract: PB1771
Type: Publication Only
Background
Chronic lymphocytic leukemia (B-CLL) and mantle cell lymphoma (MCL) share many features and their differential diagnosis may be challenging, especially when a leukemic picture alone is present. Monoclonal antibody panels are often useful, with CD23 being the most reliable. In the CD5+/CD10- subgroup cases with CD23+ cells are usually classified as CLL, whereas CD23 – cells are diagnosed as MCL. However, the immunphenotypic profile of MCL cells is a quite heterogeneous, and cases of CLL and MCL can frequently overlap to a significant degree. MCL diagnosis should be confirmed by immunohistochemical cyclin D1 detection, sometimes with equivocal or even negative results. Other cytofluorimetric, cytogenetics or molecular techniques are reliable but not widely available.
Aims
B-CLL leukemic cells express CD23, CD22, CD38, CD79b, CD200 and CD43 antigens may improve the distinction between CLL and MCL cases. Both CD200 and CD43 are used in clinical cytometry laboratories for a long time now,but need for harmonization
Methods
We investigated by 5 color multiparametric flow cytometry 357 patients (241 males and 116 females; median age of 68±10,6 years) diagnosed with B-cell LPD were studied. According to the WHO criteria (R), patients were grouped as follows: 308 cases CLL,31 cases MCL, 18 cases HCL . Median PB lymphocyte counts at diagnosis were of 19.8 × 109 lymphocytes/l (range: 0.8–274 × 109 lymphocytes/l). Diagnosis of all MCL was confirmed by immunohistochemisrty detection of cyclin D1 or detection of t (11:14) by FISH. The monoclonal antibodies (MoAbs) used for flow cytometry labeling were obtained from the Beckman Coulter Company (BC, Florida, USA). CD45, CD79b, CD3, CD5 FITC, CD10 PE, CD11c, CD19, CD20, CD22, CD23, CD25, CD38, CD103, FMC7, CD43 (clone DFT1), Kappa, Lambda, CD200 (clone OX2, Becton/Dickinson Biosciences-BD, USA) MoAbs were used for this purpose
Results
We found in one CLL case CD200 negative, and one case CD43 negative. However we have not observed any CD23 negative in all CLL cases. We observed 10 MCL cases CD23+, 3 cases CD200 positive and 2 cases CD43 positive. CD200 appeared a valuable marker in the differential diagnosis of CLL and MCL (p<0.001). As for CD43 expression in CLL, it was positive in 297 (96.4%) cases but negative in only 11 (3.6%) cases while it was negative in 20 (64.5%) and positive in 11 (38.5%) cases. CD43 was significantly different between CLL and MCL. In the MCL group, the proportion of the CD43 cases was significantly higher (p<0.001), CD38,CD22,CD79b are not significantly.
Conclusion
We concluded that although CD 23, CD22, CD79b, CD38 is not a useful marker in discrimination of CLL and MCL, CD43 and CD200 used together in routine panels could be of diagnostic utility in excluding MCL diagnosis. However, as with other markers, the use of these markers may also be flawed by heterogeneous distribution and variable expression. Therefore, standardized sampling and staining for flow cytometry and specific techniques should be primarily defined, and then followed by the evaluation of these markers and harmonization studies in larger and more diverse patient populations.
Session topic: E-poster
Keyword(s): Chronic lymphocytic leukemia, Flow cytometry
Type: Publication Only
Background
Chronic lymphocytic leukemia (B-CLL) and mantle cell lymphoma (MCL) share many features and their differential diagnosis may be challenging, especially when a leukemic picture alone is present. Monoclonal antibody panels are often useful, with CD23 being the most reliable. In the CD5+/CD10- subgroup cases with CD23+ cells are usually classified as CLL, whereas CD23 – cells are diagnosed as MCL. However, the immunphenotypic profile of MCL cells is a quite heterogeneous, and cases of CLL and MCL can frequently overlap to a significant degree. MCL diagnosis should be confirmed by immunohistochemical cyclin D1 detection, sometimes with equivocal or even negative results. Other cytofluorimetric, cytogenetics or molecular techniques are reliable but not widely available.
Aims
B-CLL leukemic cells express CD23, CD22, CD38, CD79b, CD200 and CD43 antigens may improve the distinction between CLL and MCL cases. Both CD200 and CD43 are used in clinical cytometry laboratories for a long time now,but need for harmonization
Methods
We investigated by 5 color multiparametric flow cytometry 357 patients (241 males and 116 females; median age of 68±10,6 years) diagnosed with B-cell LPD were studied. According to the WHO criteria (R), patients were grouped as follows: 308 cases CLL,31 cases MCL, 18 cases HCL . Median PB lymphocyte counts at diagnosis were of 19.8 × 109 lymphocytes/l (range: 0.8–274 × 109 lymphocytes/l). Diagnosis of all MCL was confirmed by immunohistochemisrty detection of cyclin D1 or detection of t (11:14) by FISH. The monoclonal antibodies (MoAbs) used for flow cytometry labeling were obtained from the Beckman Coulter Company (BC, Florida, USA). CD45, CD79b, CD3, CD5 FITC, CD10 PE, CD11c, CD19, CD20, CD22, CD23, CD25, CD38, CD103, FMC7, CD43 (clone DFT1), Kappa, Lambda, CD200 (clone OX2, Becton/Dickinson Biosciences-BD, USA) MoAbs were used for this purpose
Results
We found in one CLL case CD200 negative, and one case CD43 negative. However we have not observed any CD23 negative in all CLL cases. We observed 10 MCL cases CD23+, 3 cases CD200 positive and 2 cases CD43 positive. CD200 appeared a valuable marker in the differential diagnosis of CLL and MCL (p<0.001). As for CD43 expression in CLL, it was positive in 297 (96.4%) cases but negative in only 11 (3.6%) cases while it was negative in 20 (64.5%) and positive in 11 (38.5%) cases. CD43 was significantly different between CLL and MCL. In the MCL group, the proportion of the CD43 cases was significantly higher (p<0.001), CD38,CD22,CD79b are not significantly.
Conclusion
We concluded that although CD 23, CD22, CD79b, CD38 is not a useful marker in discrimination of CLL and MCL, CD43 and CD200 used together in routine panels could be of diagnostic utility in excluding MCL diagnosis. However, as with other markers, the use of these markers may also be flawed by heterogeneous distribution and variable expression. Therefore, standardized sampling and staining for flow cytometry and specific techniques should be primarily defined, and then followed by the evaluation of these markers and harmonization studies in larger and more diverse patient populations.
Session topic: E-poster
Keyword(s): Chronic lymphocytic leukemia, Flow cytometry
Abstract: PB1771
Type: Publication Only
Background
Chronic lymphocytic leukemia (B-CLL) and mantle cell lymphoma (MCL) share many features and their differential diagnosis may be challenging, especially when a leukemic picture alone is present. Monoclonal antibody panels are often useful, with CD23 being the most reliable. In the CD5+/CD10- subgroup cases with CD23+ cells are usually classified as CLL, whereas CD23 – cells are diagnosed as MCL. However, the immunphenotypic profile of MCL cells is a quite heterogeneous, and cases of CLL and MCL can frequently overlap to a significant degree. MCL diagnosis should be confirmed by immunohistochemical cyclin D1 detection, sometimes with equivocal or even negative results. Other cytofluorimetric, cytogenetics or molecular techniques are reliable but not widely available.
Aims
B-CLL leukemic cells express CD23, CD22, CD38, CD79b, CD200 and CD43 antigens may improve the distinction between CLL and MCL cases. Both CD200 and CD43 are used in clinical cytometry laboratories for a long time now,but need for harmonization
Methods
We investigated by 5 color multiparametric flow cytometry 357 patients (241 males and 116 females; median age of 68±10,6 years) diagnosed with B-cell LPD were studied. According to the WHO criteria (R), patients were grouped as follows: 308 cases CLL,31 cases MCL, 18 cases HCL . Median PB lymphocyte counts at diagnosis were of 19.8 × 109 lymphocytes/l (range: 0.8–274 × 109 lymphocytes/l). Diagnosis of all MCL was confirmed by immunohistochemisrty detection of cyclin D1 or detection of t (11:14) by FISH. The monoclonal antibodies (MoAbs) used for flow cytometry labeling were obtained from the Beckman Coulter Company (BC, Florida, USA). CD45, CD79b, CD3, CD5 FITC, CD10 PE, CD11c, CD19, CD20, CD22, CD23, CD25, CD38, CD103, FMC7, CD43 (clone DFT1), Kappa, Lambda, CD200 (clone OX2, Becton/Dickinson Biosciences-BD, USA) MoAbs were used for this purpose
Results
We found in one CLL case CD200 negative, and one case CD43 negative. However we have not observed any CD23 negative in all CLL cases. We observed 10 MCL cases CD23+, 3 cases CD200 positive and 2 cases CD43 positive. CD200 appeared a valuable marker in the differential diagnosis of CLL and MCL (p<0.001). As for CD43 expression in CLL, it was positive in 297 (96.4%) cases but negative in only 11 (3.6%) cases while it was negative in 20 (64.5%) and positive in 11 (38.5%) cases. CD43 was significantly different between CLL and MCL. In the MCL group, the proportion of the CD43 cases was significantly higher (p<0.001), CD38,CD22,CD79b are not significantly.
Conclusion
We concluded that although CD 23, CD22, CD79b, CD38 is not a useful marker in discrimination of CLL and MCL, CD43 and CD200 used together in routine panels could be of diagnostic utility in excluding MCL diagnosis. However, as with other markers, the use of these markers may also be flawed by heterogeneous distribution and variable expression. Therefore, standardized sampling and staining for flow cytometry and specific techniques should be primarily defined, and then followed by the evaluation of these markers and harmonization studies in larger and more diverse patient populations.
Session topic: E-poster
Keyword(s): Chronic lymphocytic leukemia, Flow cytometry
Type: Publication Only
Background
Chronic lymphocytic leukemia (B-CLL) and mantle cell lymphoma (MCL) share many features and their differential diagnosis may be challenging, especially when a leukemic picture alone is present. Monoclonal antibody panels are often useful, with CD23 being the most reliable. In the CD5+/CD10- subgroup cases with CD23+ cells are usually classified as CLL, whereas CD23 – cells are diagnosed as MCL. However, the immunphenotypic profile of MCL cells is a quite heterogeneous, and cases of CLL and MCL can frequently overlap to a significant degree. MCL diagnosis should be confirmed by immunohistochemical cyclin D1 detection, sometimes with equivocal or even negative results. Other cytofluorimetric, cytogenetics or molecular techniques are reliable but not widely available.
Aims
B-CLL leukemic cells express CD23, CD22, CD38, CD79b, CD200 and CD43 antigens may improve the distinction between CLL and MCL cases. Both CD200 and CD43 are used in clinical cytometry laboratories for a long time now,but need for harmonization
Methods
We investigated by 5 color multiparametric flow cytometry 357 patients (241 males and 116 females; median age of 68±10,6 years) diagnosed with B-cell LPD were studied. According to the WHO criteria (R), patients were grouped as follows: 308 cases CLL,31 cases MCL, 18 cases HCL . Median PB lymphocyte counts at diagnosis were of 19.8 × 109 lymphocytes/l (range: 0.8–274 × 109 lymphocytes/l). Diagnosis of all MCL was confirmed by immunohistochemisrty detection of cyclin D1 or detection of t (11:14) by FISH. The monoclonal antibodies (MoAbs) used for flow cytometry labeling were obtained from the Beckman Coulter Company (BC, Florida, USA). CD45, CD79b, CD3, CD5 FITC, CD10 PE, CD11c, CD19, CD20, CD22, CD23, CD25, CD38, CD103, FMC7, CD43 (clone DFT1), Kappa, Lambda, CD200 (clone OX2, Becton/Dickinson Biosciences-BD, USA) MoAbs were used for this purpose
Results
We found in one CLL case CD200 negative, and one case CD43 negative. However we have not observed any CD23 negative in all CLL cases. We observed 10 MCL cases CD23+, 3 cases CD200 positive and 2 cases CD43 positive. CD200 appeared a valuable marker in the differential diagnosis of CLL and MCL (p<0.001). As for CD43 expression in CLL, it was positive in 297 (96.4%) cases but negative in only 11 (3.6%) cases while it was negative in 20 (64.5%) and positive in 11 (38.5%) cases. CD43 was significantly different between CLL and MCL. In the MCL group, the proportion of the CD43 cases was significantly higher (p<0.001), CD38,CD22,CD79b are not significantly.
Conclusion
We concluded that although CD 23, CD22, CD79b, CD38 is not a useful marker in discrimination of CLL and MCL, CD43 and CD200 used together in routine panels could be of diagnostic utility in excluding MCL diagnosis. However, as with other markers, the use of these markers may also be flawed by heterogeneous distribution and variable expression. Therefore, standardized sampling and staining for flow cytometry and specific techniques should be primarily defined, and then followed by the evaluation of these markers and harmonization studies in larger and more diverse patient populations.
Session topic: E-poster
Keyword(s): Chronic lymphocytic leukemia, Flow cytometry
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