Srpski arhiv za celokupno lekarstvo 2014 Volume 142, Issue 3-4, Pages: 197-203
https://doi.org/10.2298/SARH1404197D
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The role of immunophenotyping in differential diagnosis of chronic lymphocytic leukemia
Dragović-Ivančević Tijana (Clinic of Hematology, Clinical Center of Serbia, Belgrade)
Kraguljac-Kurtović Nada (Clinic of Hematology, Clinical Center of Serbia, Belgrade)
Knežević Vesna (Clinic of Hematology, Clinical Center of Serbia, Belgrade)
Bogdanović Andrija (Clinic of Hematology, Clinical Center of Serbia, Belgrade + Faculty of Medicine, Belgrade)
Mihaljević Biljana (Clinic of Hematology, Clinical Center of Serbia, Belgrade + Faculty of Medicine, Belgrade)
Božić Biljana (Faculty of Biology, Belgrade)
Gotić Mirjana (Clinic of Hematology, Clinical Center of Serbia, Belgrade + Faculty of Medicine, Belgrade)
Introduction. Accurate diagnosis of chronic lymphocytic leukemia (CLL)
acquires immunophenotyping by flow cytometry in order to facilitate
differential diagnosis between CLL and other mature B-cell neoplasms (MBCN).
Objective. The aim of this study was to define immunological profile of CLL
cells. Methods. Immunophenotyping by flow cytometry was performed on
peripheral blood specimens at diagnosis in the group of 211 patients with de
novo MBCN. Results. Absolute count of B-cells was significantly increased in
all MBCN patients comparing to healthy control group (p<0.05). B-cell
monoclonality was detected in 96% of all MBCN patients, by using surface
immunoglobulin (sIg) light chain restriction. B-cell antigens, CD19, CD20,
CD22, were expressed with very high frequency in CLL and other MBCN. In
comparison with other MBCN, in CLL group, the frequency of expression was
higher for CD5 and CD23 (p<0.0001), though lower for FMC7 antigen (p<0.0001).
CLL patients were characterized by lower expression patterns of CD20, CD22,
CD79b, and sIg (p<0.0001) as well as higher expression pattern of CD5 antigen
(p<0.05). Correlation between the final diagnosis of MBCN and values of CLL
scoring system showed that the majority of CLL patients (97%) had higher
values (5 or 4) whereas the majority of other MBCN patients (96%) had lower
score values (0-3). Conclusion. Our results have shown that characteristic
immunophenotype which differentiates CLL from other MBCN is defined by
following marker combination - CD19+ CD20+low CD22+low CD5+high CD23+ FMC7-
CD79b+low sIg+low. CLL score values of 5 or 4 points are highly suggestive
for diagnosis of CLL.
Keywords: chronic lymphocytic leukemia, immunophenotyping, flow cytometry