The Diagnostic Value of Flow Cytometry Imunophenotyping in an Albanian Patient Population with a Preliminary Clinical Diagnosis of Chronic Lymphocytic Leukemia

Authors

  • Valentina Semanaj 1University Hospital Center of Tirana, Immunology, Tirana
  • Arbi Pecani University Hospital Center of Tirana, Immunology, Tirana
  • Teuta Dedej University Hospital Center of Tirana, Clinical Laboratory, Tirana
  • Alma Barbullushi University Hospital Center of Tirana, Clinical Laboratory, Tirana
  • Zamira Ylli University Hospital Center of Tirana, Immunology, Tirana
  • Teuta Curaj University Hospital Center of Tirana, Immunology, Tirana
  • Polikron Pulluqi University Hospital Center of Tirana, Hematology, Tirana
  • Tatjana Caja University Hospital Center of Tirana, Hematology, Tirana
  • Adela Perolla University Hospital Center of Tirana, Hematology, Tirana
  • Arben Ivanaj University Hospital Center of Tirana, Hematology, Tirana
  • Pal Xhumari University Hospital Center of Tirana, Hematology, Tirana
  • Genc Sulcebe University Hospital Center of Tirana, Immunology, Tirana

DOI:

https://doi.org/10.3889/oamjms.2014.009

Keywords:

Chronic lymphocytic leukemia, immunophenotyping, flow cytometry, monoclonal antibodies, lymphoma.

Abstract

Objective: Based on the flow cytometry multiparametric immunophenotyping methodology we studied some useful cell marker criteria needed for the practical differentiation of the chronic lymphocytic leukemia from other chronic limphoproliferative diseases with a leukemic component.

Materials and Methods: The applied methodology is a four color flow cytometry multiparametric immunophenotyping technique using EDTA blood samples taken from 84 consecutive patients diagnosed with CLL through a preliminary clinical and white blood cell examination. The following fluorescent stained monoclonal antibodies were used: CD3, CD4, CD5, CD8, CD11c, CD19, CD20, CD23, CD25, FMC7 and kappa/lambda light chains.

Results: From the 84 individuals tested, 2 out of them (2.4%) resulted with a abnormal T-cell population while 82 (97.6%) showed a pathological B cell line. 58 (69.1%) patients resulted with typical CLL markers (CD19+CD5+CD23+) while 5 (5.9%) of them presented a non typical chronic lymphocytic leukemia profile (CD19+CD5+CD23-). 19 (22.6%) out of patients displayed an abnormal CD19+CD5- B cell population. A statistically significant correlation was found between the clinical stage of CLL and the positivity for the CD38 marker (p=0.04).

Conclusion: Flow cytometry immunophenotyping is a fundamental examination for the final diagnosis of chronic lymphocytic leukemia. The expression of CD38+ in CLL patients stands for a more advanced clinical stage.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Rawstron AC, Bennett FL, Connor SJM, Kwok M, Fenoton JAL, Plummer M, De Tute R, Owen RG, Richards SJ, Jack AS, Hillmen P. Monoclonal B-cell lymphocytosis and chronic lymphocitic Leukemia. N Engl J Med. 2008; 359:575-83. DOI: https://doi.org/10.1056/NEJMoa075290

Chiorazzi N, Rai KR, Ferrarini M. Chronic lymphocytic leukemia. N Engl J Med. 2005; 352: 804-15. DOI: https://doi.org/10.1056/NEJMra041720

Gribben JG. Molecular profiling in CLL. Hematology Am Soc Hematol Educ Program. 2008:444-9. DOI: https://doi.org/10.1182/asheducation-2008.1.444

Zenz T, Mertens D, Kuppers R, Dohner H, Stilgenbauer S. From pathogenesis to treatment of chronic lymphocytic leukemia. Nat Rev Cancer. 2010; 10: 37-50. DOI: https://doi.org/10.1038/nrc2764

Montserrat E. New prognostic markers in CLL. Hematology Am Soc Hematol Educ Program. 2006:279-84. DOI: https://doi.org/10.1182/asheducation-2006.1.279

Craig FE, Foon KA. Flow Cytometric immunophenotyping for hematologic neoplasms. Blood. 2008; 111: 3941-3967. DOI: https://doi.org/10.1182/blood-2007-11-120535

Ho K. A, Hill S, Preobrazhensky N. S, Miller E. M, Chen Z, Bahler WD. Small B-Cell Neoplasms With Typical Mantle Cell Lymphoma Immunophenotypes Often Include Chronic Lymphocytic Leukemias. AJCP. 2009;131: 27-32. DOI: https://doi.org/10.1309/AJCPPAG4VR4IPGHZ

Rai KR, Sawitsky A, Cronkite EP, Chanana AD, Levy RN, Pasternack BS. Clinical staging of chronic lymphocytic leukemia. Blood. 1975; 46: 219-2348. DOI: https://doi.org/10.1182/blood.V46.2.219.219

Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, Hillmen P, Keating MJ, Montserrat E, Rai KR, Kipps TJ. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute–Working Group 1996 guidelines. Blood. 2008;111 (12): 5446-56. DOI: https://doi.org/10.1182/blood-2007-06-093906

Habib LK, Finn WG. Unsupervised immunophenotypic profiling of chronic lymphocytic leukemia. Cytometry B Clin Cytom. 2006; 70: 124-35. DOI: https://doi.org/10.1002/cyto.b.20091

Orfao A, Lopez A, Flores J, Almeida J, Vidriales B, Perez J, Kneba M, Macintyre E, Parreira A, Richards S, Szcezepanski T, Trka J, Van der Velden VHJ, Van Dongen JJM. Diagnosis of hematological malignancies: new applications for flow cytometry . Hematology (EHA). 2006; 2: 6-13.

Hu Y, Golightly M. CD5-positive, small B-Cell lymphoproliferative disorders: Aberrant Findings of CLL/SLL and MCL. N A J Med Sci. 2010; 3(4): 181-186. DOI: https://doi.org/10.7156/v3i4p181

Vaughan J, Harrington AM, Hari PN, Kroft SH, Olteanu H. Immunophenotypic stability of Sézary cells by flow cytometry: usefulness of flow cytometry in assessing response to and guiding alemtuzumab therapy. Am J Clin Pathol. 2012; 137: 403-11. DOI: https://doi.org/10.1309/AJCP7QHH5XASTJPL

Foucar K. Mature T-Cell leukemias including T-prolymphocytic leukemia, adult T-cell leukemia/lymphoma,and Sézary syndrome. Am J Clin Pathol. 2007; 127: 496-510. DOI: https://doi.org/10.1309/KWJYBCCGTB90B6AE

Davis BH, Holden JT, Bene MC. 2006 Bethesda International Consensus recommendations on the flow cytometric immunophenotypic analysis of hematolymphoid neoplasia: medical indications. Cytometry B Clin Cytom. 2007; 72B: S5-S13. DOI: https://doi.org/10.1002/cyto.b.20365

Landgren O, Albitar M, Abbasi F. B cell clones as early markers for chronic lymphocytic leukemia. N Engl J Med. 2009; 360: 659-67. DOI: https://doi.org/10.1056/NEJMoa0806122

Bennett JM, Catovsky D, Daniell MT, Flandrin G, Galton DA, Gralnick HR, Sultan C. Proposals for the classification of chronic (mature) B and T lymphoid leukaemias. J Clin Pathol. 1989; 42: 567-584. DOI: https://doi.org/10.1136/jcp.42.6.567

Cuneo A. Classification of B-cell chronic lymphoproliferative disorders (CLD). Atlas Genet Cytogenet Oncol Haematol. 2000; 4(1): 22-23.

Cherie H, Dunphy, MD. Applications of Flow Cytometry and Immunohistochemistry to Diagnostic Hematopathology. Arch Pathol Lab Med. 2004; 128: 1004–1022. DOI: https://doi.org/10.5858/2004-128-1004-AOFCAI

Barna C, Reiniger L, Tatrai P,Kooper L, Matolcsy A. The cut-of levels of CD23 expresion in the differential diagnosis of MCL and CLL. Hemato Oncol. 2008; 26: 167-170. DOI: https://doi.org/10.1002/hon.855

Catovsky D, Muller-Hermelink HK, Montserrat E, Harris NL. B-cell prolymphocytic leukaemia. In: Jaffe ES, Harris NL, Stein H, Vardiman JW, eds. World Health Organization Classiï¬cation of Tumours: Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC Press. 2001; 131-132.

Bentz JS, Rowe LR, Anderson SR, Gupta PK, McGrath CM. Rapid detection of the t(11;14) translocation in mantle cell lymphoma by interphase fluorescence in situ hybridization on archival cytopathologic material. Cancer Cytopathology. 2004; 102: 124–131. DOI: https://doi.org/10.1002/cncr.11934

Specht K, Kremer M, Müller U, Dirnhofer S, Rosemann M, Höfler H, Martinez L.Q, Fend F. Identification of Cyclin D1 mRNA Overexpression in B-Cell Neoplasias by Real-Time Reverse Transcription-PCR of Microdissected Paraffin Sections. Clin Cancer Res. 2002; 8:2902.

Garcia DP, Rooney MT, Ahmad E, Bruce H, Davis BH. Diagnostic usefulness of CD23 and FMC-7 antigen expression patterns in B-Cell lymphoma classification. Am J Clin Pathol. 2001; 115: 258-265. DOI: https://doi.org/10.1309/VWTK-XYT5-D0DK-06HQ

Monaghan SA, Peterson LC, James C, Marszalek L, Khoong A, Bachta DJ, Karpus WJ, Goolsby CL. Pan B-cell markers are not redundant in analysis of chronic lymphocytic leukemia. Cytometry Part B. 2003: 56B; 30–42. DOI: https://doi.org/10.1002/cyto.b.10049

Deans JP, Polyak MJ. FMC7 is an epitope of CD20. Blood. 2008; 111: 2492-94. DOI: https://doi.org/10.1182/blood-2007-11-126243

Rassenti LZ, Kipps TJ. Clinical Utility of Assessing Zap-70 and CD38 in Chronic Lymphocytic Leukemia. Moores cancer center University of California. San Diego, 2006: 209-213. DOI: https://doi.org/10.1002/cyto.b.20129

Keating IS. CD38 expression as an important prognostic factor in B-CLL Blood. 2003; 102: 2146-2155. DOI: https://doi.org/10.1182/blood-2003-03-0989

D'Arena G, Nunziata G, Coppola G, Vigliotti ML, Tartarone A,Carpinelli N, Matera R, Bisogno RC, Pistolese G, Di Renzo N. CD38 expression does not change in B-cell chronic lymphocytic leukemia. Blood. 2002; 100: 3052-3053. DOI: https://doi.org/10.1182/blood-2002-07-2249

Gribben JG. How I treat CLL up front. Blood. 2010; 115: 187-197. DOI: https://doi.org/10.1182/blood-2009-08-207126

Downloads

Published

2014-03-15

How to Cite

1.
Semanaj V, Pecani A, Dedej T, Barbullushi A, Ylli Z, Curaj T, Pulluqi P, Caja T, Perolla A, Ivanaj A, Xhumari P, Sulcebe G. The Diagnostic Value of Flow Cytometry Imunophenotyping in an Albanian Patient Population with a Preliminary Clinical Diagnosis of Chronic Lymphocytic Leukemia. Open Access Maced J Med Sci [Internet]. 2014 Mar. 15 [cited 2024 Apr. 26];2(1):51-5. Available from: https://oamjms.eu/index.php/mjms/article/view

Issue

Vol. 2 No. 1 (2014): Mar 15 (OAMJMS)

Section

B - Clinical Sciences

License

http://creativecommons.org/licenses/by-nc/4.0

Crossref
Scopus
Google Scholar
Europe PMC