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Matos DM. CD5-negative chronic lymphocytic leukemia: Does this entity really exist? CYTOMETRY. PART B, CLINICAL CYTOMETRY 2024; 106:126-137. [PMID: 38017706 DOI: 10.1002/cyto.b.22151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 10/19/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Affiliation(s)
- Daniel Mazza Matos
- Flow Cytometry Section, Cell Processing Center (CPC), Center of Hematology and Hemotherapy of Ceará (HEMOCE), Fortaleza, Brazil
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2
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Robak T, Krawczyńska A, Cebula-Obrzut B, Urbaniak M, Iskierka-Jażdżewska E, Robak P. Atypical Chronic Lymphocytic Leukemia-The Current Status. Cancers (Basel) 2023; 15:4427. [PMID: 37760396 PMCID: PMC10527541 DOI: 10.3390/cancers15184427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/17/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
A diagnosis of typical chronic lymphocytic leukemia (CLL) requires the presence of ≥5000 clonal B-lymphocytes/μL, the coexistence of CD19, CD20, CD5, and CD23, the restriction of light chain immunoglobulin, and the lack of expression of antigens CD22 and CD79b. Atypical CLL (aCLL) can be distinguished from typical CLL morphologically and immunophenotypically. Morphologically atypical CLL cells have been defined mainly as large, atypical forms, prolymphocytes, or cleaved cells. However, current aCLL diagnostics rely more on immunophenotypic characteristics rather than atypical morphology. Immunophenotypically, atypical CLL differs from classic CLL in the lack of expression of one or fewer surface antigens, most commonly CD5 and CD23, and the patient does not meet the criteria for a diagnosis of any other B-cell lymphoid malignancy. Morphologically atypical CLL has more aggressive clinical behavior and worse prognosis than classic CLL. Patients with aCLL are more likely to display markers associated with poor prognosis, including trisomy 12, unmutated IGVH, and CD38 expression, compared with classic CLL. However, no standard or commonly accepted criteria exist for differentiating aCLL from classic CLL and the clinical significance of aCLL is still under debate. This review summarizes the current state of knowledge on the morphological, immunophenotypic, and genetic abnormalities of aCLL.
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Affiliation(s)
- Tadeusz Robak
- Department of Hematology, Medical University of Lodz, 90-647 Lodz, Poland; (A.K.); (B.C.-O.); (M.U.); (E.I.-J.); (P.R.)
- Department of General Hematology, Copernicus Memorial Hospital, 93-513 Lodz, Poland
| | - Anna Krawczyńska
- Department of Hematology, Medical University of Lodz, 90-647 Lodz, Poland; (A.K.); (B.C.-O.); (M.U.); (E.I.-J.); (P.R.)
- Department of General Hematology, Copernicus Memorial Hospital, 93-513 Lodz, Poland
| | - Barbara Cebula-Obrzut
- Department of Hematology, Medical University of Lodz, 90-647 Lodz, Poland; (A.K.); (B.C.-O.); (M.U.); (E.I.-J.); (P.R.)
- Department of General Hematology, Copernicus Memorial Hospital, 93-513 Lodz, Poland
| | - Marta Urbaniak
- Department of Hematology, Medical University of Lodz, 90-647 Lodz, Poland; (A.K.); (B.C.-O.); (M.U.); (E.I.-J.); (P.R.)
- Department of General Hematology, Copernicus Memorial Hospital, 93-513 Lodz, Poland
| | - Elżbieta Iskierka-Jażdżewska
- Department of Hematology, Medical University of Lodz, 90-647 Lodz, Poland; (A.K.); (B.C.-O.); (M.U.); (E.I.-J.); (P.R.)
- Department of General Hematology, Copernicus Memorial Hospital, 93-513 Lodz, Poland
| | - Paweł Robak
- Department of Hematology, Medical University of Lodz, 90-647 Lodz, Poland; (A.K.); (B.C.-O.); (M.U.); (E.I.-J.); (P.R.)
- Department of Hematooncology, Copernicus Memorial Hospital, 93-513 Lodz, Poland
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3
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Friedman DR, Guadalupe E, Volkheimer A, Moore JO, Weinberg JB. Clinical outcomes in chronic lymphocytic leukaemia associated with expression of CD5, a negative regulator of B-cell receptor signalling. Br J Haematol 2018; 183:747-754. [PMID: 30407619 DOI: 10.1111/bjh.15632] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/07/2018] [Indexed: 11/30/2022]
Abstract
Chronic lymphocytic leukaemia (CLL) is characterized by expression of CD5 on clonal B cells, and is partly driven by activated B-cell receptor (BCR) signalling. While CD5 is known to be a negative regulator of BCR signalling, it is unknown if variability in CD5 expression exists among patients and whether CLL cell CD5 expression affects CLL clinical outcomes. We assessed the extent to which CD5 expression is correlated with clinical outcomes, and whether this information adds to currently used prognostic markers. We evaluated CD5 expression from 1275 blood samples, established prognostic markers and time to event data from 423 CLL patients followed at the Duke University and Durham VA Medical Centers. CD5 median fluorescence intensity (MFI) was largely stable over time in individual patients, but ranged between 0·5 and 760 in the entire cohort. Lower CD5 MFI was significantly associated with a shorter time to first therapy. CD5 MFI, combined with established clinical and molecular prognostic markers, significantly improved risk-stratification. CD5 may affect disease outcomes by suppressing signalling through the BCR. Thus, a strategy to modulate CLL cell CD5 expression or function could be a therapeutic approach in CLL.
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Affiliation(s)
- Daphne R Friedman
- Division of Medical Oncology, Duke University Medical Center, Durham, NC, USA.,Medicine Service, Durham VA Medical Center, Durham, NC, USA
| | - Eross Guadalupe
- Medicine Service, Durham VA Medical Center, Durham, NC, USA.,Division of Hematology, Duke University Medical Center, Durham, NC, USA
| | - Alicia Volkheimer
- Medicine Service, Durham VA Medical Center, Durham, NC, USA.,Division of Hematology, Duke University Medical Center, Durham, NC, USA
| | - Joseph O Moore
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - J Brice Weinberg
- Medicine Service, Durham VA Medical Center, Durham, NC, USA.,Division of Hematology, Duke University Medical Center, Durham, NC, USA
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Sorigue M, Junca J. Atypical chronic lymphocytic leukemia: Brief historical overview and current usage of an equivocal concept. Int J Lab Hematol 2018; 41:e17-e19. [DOI: 10.1111/ijlh.12930] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Marc Sorigue
- Hematology Laboratory ICO‐Hospital Germans Trias i Pujol Josep Carreras Leukemia Research Institute Universitat Autònoma de Barcelona Badalona Spain
| | - Jordi Junca
- Hematology Laboratory ICO‐Hospital Germans Trias i Pujol Josep Carreras Leukemia Research Institute Universitat Autònoma de Barcelona Badalona Spain
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5
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Demir C, Kara E, Ekinci Ö, Ebinç S. Clinical and Laboratory Features of CD5-Negative Chronic Lymphocytic Leukemia. Med Sci Monit 2017; 23:2137-2142. [PMID: 28473690 PMCID: PMC5427937 DOI: 10.12659/msm.901781] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Chronic lymphocytic leukemia (CLL) usually expresses CD5 antigen. However, 7–20% of patients are CD5 negative. We report here a series of 19 CD5-negative B-CLL cases. Material/Methods We reviewed 19 consecutive CD5-negative B-CLL cases seen in our medical center from 2009 to 2015 and compared them with 105 CD5-positive B-CLL cases. The two groups were compared in terms of clinical parameters, laboratory parameters, and survival characteristics. Results Lymphadenopathy was present in 31.5% of the CD5-negative group and 51.4% of the CD5-positive group (p=0.029). Splenomegaly was present in 42.1% of the CD5-negative group and 16.1% of the CD5-positive group (p=0.029). There was no difference between the groups in terms of Binet A, B, and C stages (p=0.118, p=0.051, and p=0.882, respectively). The median thrombocyte count was 144×109/L and 160×109/L in the CD5-negative and CD5-positive groups, respectively (p=0.044). There was no difference between the two groups in terms of median neutrophil count (p=0.169). The mean lymphocyte count was 43.2±4.0×109/L and 36.7±3.2×109/L in the CD5-negative and CD5-positive groups, respectively (p=0.001). There was no difference between the groups in terms of autoimmune hemolytic anemia and autoimmune thrombocytopenia. In five-year follow-up, 84.2% of CD5-negative patients and 90.5% of CD5-positive patients were alive (p=0.393). Conclusions We found more isolated splenomegaly, less lymphadenopathy, a higher lymphocyte count, and a lower thrombocyte count in the CD5-negative group. There was no difference between the groups in terms of clinical stage, autoimmune phenomena, hemoglobin and neutrophil count, and survival.
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Affiliation(s)
- Cengiz Demir
- Department of Hematology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Erdal Kara
- Department of Hematology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Ömer Ekinci
- Department of Hematology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
| | - Senar Ebinç
- Department of Hematology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
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6
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Sorigue M, Juncà J, Sarrate E, Grau J. Expression of CD43 in chronic lymphoproliferative leukemias. CYTOMETRY PART B-CLINICAL CYTOMETRY 2017; 94:136-142. [PMID: 28073173 DOI: 10.1002/cyto.b.21509] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 12/27/2016] [Accepted: 01/06/2017] [Indexed: 01/25/2023]
Abstract
BACKGROUND CD43 has been used on histological samples for the differential diagnosis of lymphoproliferative disorders but there is scarce data on its use by flow cytometry (FC). We set out to characterize the expression of CD43 by FC in B-cell lymphoproliferative disorders and to determine its possible role in the differential diagnosis of these malignancies. METHODS We analyzed the expression of CD43 in clonal B-cell lymphoproliferative disorders with exclusive peripheral blood and/or bone marrow involvement based on their Moreau chronic lymphocytic leukemia (CLL) score with particular emphasis on Moreau CLL score 3 (MS3) cases, which often present a diagnostic challenge. The cohort included 433 CLL (score 4-5), 34 MS3 and 166 lymphoproliferative disorders with lower scores. RESULTS Generally, the higher the Moreau CLL score, the higher CD43-positivity (425/443 [96%] for CLL, 23/34 [67%] for MS3 and 18/166 [11%] for cases with lower scores). MS3 cases constituted 5.4% of all cases and were more frequently CD5, CD200, CD43-positive and had del(q13) than score 0-2 cases. Among MS3 cases, del(13q) cases were predominantly CD43-positive (12/13). CONCLUSIONS The frequency of CD43-positivity increases sharply with the Moreau score. MS3 cases seem to include both CLL and non-CLL lymphoproliferative disorders and CD43 could aid in the differential diagnosis between the two. However, studies analyzing the correlation between CD43 expression and the underlying biologic changes of these cases are warranted. © 2017 International Clinical Cytometry Society.
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Affiliation(s)
- Marc Sorigue
- Department of Laboratory Hematology, ICO-Badalona, Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autonoma de Barcelona, Badalona, Spain
| | - Jordi Juncà
- Department of Laboratory Hematology, ICO-Badalona, Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autonoma de Barcelona, Badalona, Spain
| | - Edurne Sarrate
- Department of Laboratory Hematology, Hospital Universitari Germans Trias i Pujol, Universitat Autonoma de Barcelona, Badalona, Spain
| | - Javier Grau
- Department of Laboratory Hematology, ICO-Badalona, Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autonoma de Barcelona, Badalona, Spain
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7
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Min F, Zhou W, Zhai L, Gao X, Zhang L, Li J. [A case of CD5-negative mantle cell lymphoma report and literatures review]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2015; 36:63-5. [PMID: 25641151 PMCID: PMC7343037 DOI: 10.3760/cma.j.issn.0253-2727.2015.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Fengling Min
- Department of Hematology, The First People's Hospital,Yangzhou, Jiangsu 225001, China
| | - Wei Zhou
- Department of Hematology, The First People's Hospital,Yangzhou, Jiangsu 225001, China
| | - Lijia Zhai
- Department of Hematology, The First People's Hospital,Yangzhou, Jiangsu 225001, China
| | - Xiaohui Gao
- Department of Hematology, The First People's Hospital,Yangzhou, Jiangsu 225001, China
| | - Li'na Zhang
- Department of Hematology, The First People's Hospital,Yangzhou, Jiangsu 225001, China
| | - Jianyong Li
- Department of Hematology, The First People's Hospital,Yangzhou, Jiangsu 225001, China
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Ames PRJ, Aw D, Rainey MG. Autoimmune haemolytic anaemia emerging during Campath treatment in a patient with CD5 negative chronic lymphocytic leukaemia. Indian J Hematol Blood Transfus 2014; 30:43-5. [PMID: 25332532 DOI: 10.1007/s12288-013-0239-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 02/04/2013] [Indexed: 11/27/2022] Open
Abstract
Campath is being employed for the treatment of autoimmune haemolytic anemia (AIHA) whether or not associated to B cell chronic lymphoid leukaemia (CLL). CD5 negative CLL is relatively uncommon and runs an indolent course. We report a CD5 negative CLL patient who developed AIHA associated with cytomegalovirus infection reactivation whilst on treatment with Campath for progressive disease.
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Affiliation(s)
- Paul R J Ames
- Department of Haematology, Inverclyde Royal Hospital, Larkfield Road, Greenock, PA16 0XN Scotland, UK ; Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, 327 Mile End Rd, London, E1 4NS UK
| | - Darren Aw
- Department of Haematology, Inverclyde Royal Hospital, Larkfield Road, Greenock, PA16 0XN Scotland, UK
| | - Mervin G Rainey
- Department of Haematology, Inverclyde Royal Hospital, Larkfield Road, Greenock, PA16 0XN Scotland, UK
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9
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Bazari H, Mahindra AK, Farkash EA. Case records of the Massachusetts General Hospital. Case 3-2014. A 61-year-old woman with gastrointestinal symptoms, anemia, and acute kidney injury. N Engl J Med 2014; 370:362-73. [PMID: 24450895 DOI: 10.1056/nejmcpc1214220] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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10
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Niu S, Chan R, Berini P, Wang C, Zou S. Morphology and expression status investigations of specific surface markers on B-cell chronic lymphocytic leukemia cells. Microsc Res Tech 2013; 76:1147-53. [PMID: 23963997 DOI: 10.1002/jemt.22278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 07/22/2013] [Accepted: 07/29/2013] [Indexed: 11/06/2022]
Abstract
The morphology of cells and expression status of specific surface markers [cluster of differentiation (CD)], such as CD5, CD19, CD20, CD38, and CD45, have long been considered as the essential indicators for the diagnosis and prognosis of B-cell chronic lymphocytic leukemia (B-CLL). Clinically, it is difficult to simultaneously obtain cell morphology and distribution of surface markers with flow cytometry, especially for some surrogate markers such as CD38. Here, as an alternative and complementary prognostic method, fluorescence microscopy and image processing method are introduced to directly visualize the cells from patients and to quantitatively determine the expression status of surface markers. In this study, the morphological parameters of B-CLL cells were measured to establish the correlation between the cellular morphology and the surface marker expression. It was clear that the CD38+ and CD38- B-CLL cells from the same CD38+ patients had hardly any size differences; however, an increase in perimeter was observed for CD38- patients. Moreover, the expression level of the receptors on the cell was independent of the cell size. There was no evidence showing that the expression intensities of CD19 and CD38 were related to each other for the CD38+ B-CLL cells. On the same cells, CD5 was more selectively expressed on the cell membrane; however, the expression patterns suggested that the cell membrane of CD38- B-CLL cells contained the least expression level of CD19.
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Affiliation(s)
- Suli Niu
- National Research Council Canada, Ottawa, Ontario, Canada, K1A 0R6; Department of Chemical and Biological Engineering, University of Ottawa, Ottawa, Ontario, Canada, K1N 6N5
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11
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Okaly GVP, Nargund AR, E V, Jayanna PK, Juvva CR, Prabhudesai S. Chronic lymphoproliferative disorders at an Indian tertiary cancer centre - the panel sufficiency in the diagnosis of chronic lymphocytic leukaemia. J Clin Diagn Res 2013; 7:1366-71. [PMID: 23998067 PMCID: PMC3749637 DOI: 10.7860/jcdr/2013/5088.3130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 04/26/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Flow cytometry has come to occupy the vanguard of the high through put diagnostic techniques that have been used to differentiate between various chronic lymphoproliferative disorders (CLPD). However, economic considerations have created the need for minimal consensus panels that can yield maximum information at reasonable costs. AIMS To collect, analyse and correlate the morphologic, immunophenotypic, and the cytogenetic data from the cases of chronic lymphoproliferative disorders, which were diagnosed at an Indian speciality cancer centre. METHODS AND MATERIAL The morphology was recorded after staining the samples with the Leishman or the MGG stains. The lineage assignment was done by using three colour flow cytometry with a primary panel of antibodies. For the cytogenetic studies, the short term culture of the sample cells were arrested by using colcemid and they were G-banded by using trypsin and Giemsa stain. FISH studies were conducted by using a CLL-specific diagnostic kit. RESULTS AND CONCLUSIONS A total of 66 cases were evaluated, which had a median age of 64.5 years and a sex ratio of 2.3:1. Of these 66 cases, 40 cases were of CLL and 9 cases were of atypical CLL. 17 cases were classified as CLPD and these included 13 cases of Non-Hodgkin's Lymphoma, two cases of Hairy Cell Leukaemia, one case of Follicular Lymphoma and one case of Prolymphocytic Leukaemia. In immunophenotyping, the lack of expression of CD22 had the highest correlation with a definitive diagnosis of CLL. Cytogenetics demonstrated a classical follicular lymphoma abnormality, t (14; 18) (q32; q21), in one case. A basic minimal panel is sufficient for the routine diagnosis of CLL. However, the stratification of CLPD requires the use of more extensive panels.
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Affiliation(s)
- Geeta V Patil Okaly
- Consultant Pathologist, Triesta Rerearch & Development, Bangalore, Karnataka, India
| | | | - Venkataswamy E
- Senior Research Scientist, Triesta Rerearch & Development, Bangalore, Karnataka, India
| | - Prashanth K Jayanna
- Research Scientist, Triesta Rerearch & Development, Bangalore, Karnataka, India
| | - Chandra Rao Juvva
- Research Scientist, Triesta Rerearch & Development, Bangalore, Karnataka, India
| | - Shilpa Prabhudesai
- Consultant Pathologist, Triesta Rerearch & Development, Bangalore, Karnataka, India
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12
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Concurrent CD5-negative small lymphocytic lymphoma (SLL) and CD5-positive metastatic carcinoma of unknown primary in a lymph node biopsy. J Hematop 2012. [DOI: 10.1007/s12308-012-0153-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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13
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Murphy M, Hoss D. Cutaneous involvement by CD5-negative chronic lymphocytic leukemia (CLL)--aberrant phenotype or false negativity? Implications for immunohistochemical testing on paraffin-embedded skin specimens. J Cutan Pathol 2010; 38:73-5. [PMID: 20880388 DOI: 10.1111/j.1600-0560.2010.01620.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Lee S, Ogilvie RT, Dupre M, Gao ZH. Intravascular lymphocytosis in acute appendicitis: potential mimicry of chronic lymphocytic leukaemia. Histopathology 2010; 55:660-4. [PMID: 20002767 DOI: 10.1111/j.1365-2559.2009.03431.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIMS Intravascular lymphocytosis (IVL) in appendectomy specimens is a fairly common phenomenon but has not been described and studied in detail. The aim was to describe the IVL phenomenon in appendiceal specimens removed for appendicitis that can mimic chronic lymphocytic leukaemia and to investigate factors that could contribute to the development of IVL. METHODS AND RESULTS The clinicopathology of 100 appendectomy cases and the appendices from 20 right hemicolectomy cases were reviewed. The IVL phenomenon was more commonly seen in laparoscopic appendectomy specimens [Fisher's exact 0.011, odds ratio (OR) 3.14] and in patients <38 years old (Fisher's exact 0.012, OR 3.01). CONCLUSIONS Surgical manipulation and the patient's innate immunity are contributary factors to the development of the IVL phenomenon. Pathologists should be aware of this histological artefact in order to prevent overdiagnosis of intravascular lymphoid neoplasia.
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Affiliation(s)
- Sandra Lee
- Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, AB, Canada
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15
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Gujral S, Polampalli SN, Badrinath Y, Kumar A, P. G. S, Nair R, Gupta S, Sengar M, Nair C. Immunophenotyping of mature B-cell non Hodgkin lymphoma involving bone marrow and peripheral blood: critical analysis and insights gained at a tertiary care cancer hospital. Leuk Lymphoma 2009; 50:1290-300. [DOI: 10.1080/10428190903064824] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Hwang K, Park CJ, Park SJ, Jang S, Chi HS, Cha CH, Huh JR, Suh CW. A Case of CD5 Negative Chronic Lymphocytic Leukemia. THE KOREAN JOURNAL OF HEMATOLOGY 2009. [DOI: 10.5045/kjh.2009.44.4.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Keumrock Hwang
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Chan-Jeoung Park
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seo-jin Park
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sungsoo Jang
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hyun-Sook Chi
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Choong-Hwan Cha
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Gangnung Asan Hospital, Gangnung, Korea
| | - Joo Ryung Huh
- Department of Pathology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Cheol Won Suh
- Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
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17
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Goldaniga M, Ferrario A, Cortelazzo S, Guffanti A, Pavone E, Ambrosetti A, Marcheselli L, Rossi F, Luminari S, Rossi A, Cro L, Federico M, Lambertenghi Deliliers G, Baldini L. A multicenter retrospective clinical study of CD5/CD10-negative chronic B cell leukemias. Am J Hematol 2008; 83:349-54. [PMID: 18186522 DOI: 10.1002/ajh.21065] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
CD5-negative chronic B cell lymphoproliferative disorders in leukemic phase (B-CLPD) are heterogeneous and relatively uncommon pathologies that often lack a histopathological definition because of the absence of accessible pathological tissue. We describe the clinical features and evolution-related variables of 156 patients with CD5/CD10-negative B-CLPD (median age 66 years, range 25-86). The median follow-up was 51 months (range 6-216), and overall 3- and 5-year survival was respectively 87 and 76%; 50 patients needed therapy at diagnosis, 56 during follow-up, and 50 remained untreated until the last control. A combined clinical, histological, cytomorphological, immunophenotypical, and cytogenetic diagnostic approach allowed the complete classification of only a minority of patients as being affected by splenic marginal zone or lymphoplasmacytic lymphoma; the majority of cases remained unclassifiable. Multivariate analysis showed that the clinicohematological variables adversely related to overall survival were serum LDH levels and age, whereas high serum LDH levels, hemoglobin levels of <11 g/dl, and splenomegaly related to treatment-free time (in "wait and see" cases); only splenomegaly related to time to progression (in treated patients). In conclusion, our retrospective study describes the clinical features and variables related to evolution in a large group of patients with CD5/CD10-negative chronic B-cell lymphoid leukemias and underlines the fact that a probable lymphoplasmacytic or marginal zone normal cell origin can be supposed in such leukemic forms, but never surely demonstrated.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antigens, CD/analysis
- Antigens, Neoplasm/analysis
- B-Lymphocyte Subsets/chemistry
- B-Lymphocyte Subsets/pathology
- Disease Progression
- Female
- Flow Cytometry
- Follow-Up Studies
- Humans
- Immunophenotyping
- Karyotyping
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoproliferative Disorders/classification
- Male
- Middle Aged
- Neoplastic Stem Cells/chemistry
- Neoplastic Stem Cells/pathology
- Retrospective Studies
- Splenic Neoplasms/diagnosis
- Splenic Neoplasms/pathology
- Survival Analysis
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Affiliation(s)
- Maria Goldaniga
- UO Ematologia e Centro Trapianti di Midollo, Ospedale Maggiore, IRCCS, University of Milan, Milan, Italy.
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18
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Carulli G, Cannizzo E, Zucca A, Buda G, Orciuolo E, Marini A, Petrini M. CD45 expression in low-grade B-cell non-Hodgkin's lymphomas. Leuk Res 2007; 32:263-7. [PMID: 17692374 DOI: 10.1016/j.leukres.2007.06.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2007] [Revised: 06/07/2007] [Accepted: 06/12/2007] [Indexed: 11/17/2022]
Abstract
CD45 is a glycoprotein expressed in all lymphohemopoietic cells. Its expression increases during B-lymphocyte ontogeny. Few data are available about CD45 expression in the various types of low-grade B-cell non-Hodgkin's lymphomas (NHL). Low levels of CD45 have been reported in pathologic lymphocytes from typical chronic lymphocytic leukemia (CLL) and higher levels of this antigen have been observed in some cases of atypical CLL and in some cases of other types of NHL. One hundred and seven bone marrow samples of NHL with bone marrow infiltration were investigated: 45 typical CLL, 15 atypical CLL, 9 mantle cell lymphomas (MCL), 1 MCL with CD23 expression, 18 marginal zone lymphomas (MZL), 6 lymphoplasmacytic lymphomas (LPL), 6 follicular lymphomas (FL), and 7 hairy cell leukemias (HCL). CD45 expression was evaluated by flow cytometry: pathologic lymphocytes were identified on the basis of specific immunophenotypic profile, CD19/K or CD19/lambda co-expression. Results were expressed as median fluorescence intensity (MFI) along a 1024 linear scale. CD45 expression was measured also on autologous T-lymphocytes and a "CD45 index" was calculated as the ratio MFI of pathologic B-lymphocytes/MFI of T-lymphocytes, to normalize the results obtained. We found four CD45 expression patterns: very low in typical CLL; relatively low in MCL; intermediate intensity in MZL, LPL, and FL; very high expression in HCL. Among the atypical cases, very high CD45 expression was found in one case of CD23-negative CLL, in CD23-positive MCL, and CLL with atypical morphology. The results indicate different levels of maturation in low-grade NHL and may help to characterize such neoplasias.
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MESH Headings
- Flow Cytometry
- Humans
- Immunophenotyping
- Leukemia, Hairy Cell/metabolism
- Leukemia, Hairy Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukocyte Common Antigens/biosynthesis
- Lymphoma, Follicular/metabolism
- Lymphoma, Follicular/pathology
- Lymphoma, Mantle-Cell/metabolism
- Lymphoma, Mantle-Cell/pathology
- Lymphoma, Non-Hodgkin/metabolism
- Lymphoma, Non-Hodgkin/pathology
- Polymerase Chain Reaction
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Affiliation(s)
- Giovanni Carulli
- Division of Hematology, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Italy.
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19
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Jorgensen JL. State of the Art Symposium: flow cytometry in the diagnosis of lymphoproliferative disorders by fine-needle aspiration. Cancer 2006; 105:443-51. [PMID: 16155944 DOI: 10.1002/cncr.21455] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jeffrey L Jorgensen
- Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
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20
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Okamoto M, Nakano S, Namura K, Yamada N, Uchida R, Fuchida SI, Okano A, Ochiai N, Shimazaki C. CD5-negative chronic lymphocytic leukemia with indolent clinical course and autoimmune thrombocytopenia, successfully treated with rituximab. Am J Hematol 2004; 77:413-5. [PMID: 15551407 DOI: 10.1002/ajh.20223] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A 59-year-old male with lymphocytosis and thrombocytopenia was asymptomatic without lymphadenopathy or hepatosplenomegaly over 10 years. He was admitted to our hospital because his thrombocytopenia had worsened. The clonal lymphocytes appeared as regular small mature lymphocytes on blood films, and bone marrow biopsy showed diffuse infiltration of mature lymphocytes. However, megakaryocytes also presented. The immunophenotypic analysis by flow cytometry revealed that the lymphocytes were positive for CD19, CD20, CD22, and surface membrane immunoglobulin (SmIg) M and D-lambda and were negative for CD5, CD10, CD11c, CD23, and other lineage markers. Expression levels of CD20 and SmIg were strong. The markers were consistent with CD5- CLL with autoimmune thrombocytopenia. He received rituximab, and a rapid decrease of lymphocytes with concomitant increase of platelets was observed. A few cases of CD5- CLL with a stable clinical course have been reported, thought to be B lymphocytosis of undetermined significance (MLUS). This is the first report of CD5- CLL with indolent clinical course associated with autoimmune thrombocytopenia, successfully treated with rituximab.
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MESH Headings
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Agents/therapeutic use
- Biomarkers/analysis
- CD5 Antigens/analysis
- CD5 Antigens/immunology
- Flow Cytometry
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Male
- Middle Aged
- Purpura, Thrombocytopenic, Idiopathic/complications
- Purpura, Thrombocytopenic, Idiopathic/immunology
- Rituximab
- Treatment Outcome
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Affiliation(s)
- Masashi Okamoto
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
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