Adult lymphocytosis classification by flow cytometry
##plugins.themes.academic_pro.article.main##
Abstract
Background: Positive and differential diagnosis of chronic lymphocytic leukemia (CLL) is based on immunophenotyping analysis. CLL is searched whenever a persistent lymphocytosis is found.
aim: To evaluate the performance of flow cytometry in etiologic diagnosis of lymphocytosis. Could it allow us to distinguish CLL from other causes of lymphocytosis?
methods: Blood samples from 104 adult patients having a rate of lymphocytes> 5000 élé/mm3 persisting more than three months were analyzed using a large panel of monoclonal antibodies in three colors and Cell Quest software.
results: Lymphoproliferative B disorder was retained in 83 cases, including 50 cases of typical CLL with Matutes score≥ 4 and 12 cases of atypical CLL with Matutes score = 3 . Diagnosis of hairy cell leukemia and follicular lymphoma were guided by the respective specific antigen expression CD103 and CD10. Large granular T lymphoma (LGL-T) was the most common etiology of lymphoid T proliferation. Unusual cases of Natural Killer (NK) and NK/T proliferations were found.
Conclusion: The Flow cytometry is a powerful tool to establish lymphocytosis etiological diagnosis; it avoids invasive investigations in a large number of cases.
aim: To evaluate the performance of flow cytometry in etiologic diagnosis of lymphocytosis. Could it allow us to distinguish CLL from other causes of lymphocytosis?
methods: Blood samples from 104 adult patients having a rate of lymphocytes> 5000 élé/mm3 persisting more than three months were analyzed using a large panel of monoclonal antibodies in three colors and Cell Quest software.
results: Lymphoproliferative B disorder was retained in 83 cases, including 50 cases of typical CLL with Matutes score≥ 4 and 12 cases of atypical CLL with Matutes score = 3 . Diagnosis of hairy cell leukemia and follicular lymphoma were guided by the respective specific antigen expression CD103 and CD10. Large granular T lymphoma (LGL-T) was the most common etiology of lymphoid T proliferation. Unusual cases of Natural Killer (NK) and NK/T proliferations were found.
Conclusion: The Flow cytometry is a powerful tool to establish lymphocytosis etiological diagnosis; it avoids invasive investigations in a large number of cases.
Keywords:
Lymphocytosis, chronic lymphocytic leukemia, flow cytometry##plugins.themes.academic_pro.article.details##
References
- Sebahoun G. Hématologie Clinique et biologique, 2ème Edition 2005 page 273.
- Ginaldi L, Martinitis M, Matutes E. Levels of expression of CD 19 and CD20 in chronic B cell leukaemias. J Clin Pathol 1998; 51: 364-69.
- Robbins BA, Ellison DJ, Spinosa JC et al. Diagnostic application of two-color flow cytometry in 161 cases of hairy cell leukemia. Blood 1993;82: 1277-87.
- Troussard X. Leucémie à tricholeucocytes. Encycl Méd chir, Hématologie, 13-014-H-10, 2000 : 8.
- Sánchez ML, Almeida J, Vidriales B, et al. Incidence of phenotypic aberrations in a series of 467 patients with B chronic lymphoproliferative disorders: basis for the design of specific four-color stainings to be used for minimal residual disease investigation. Leukemia. 2002;16 :1460-9.
- Ries LAG, Pollack ES, Young JL.JR. Cancer patient survival, epidemiology and result program, 1973-79. J Nat Cancer Inst. 1983;70: 693-707.
- Rozman C, Montserrat E. Chronic lymphocytic leukemia. N Engl J Med 1995; 333: 1052- 57.
- Redaelli A, Laskin BL, Stephens JM, Botteman MF, Pashos CL. The clinical and epidemiological burden of chronic lymphocytic leukaemia. Eur J Cancer Care 2004;13: 279-87.
- Shamebo M, Gebremdhin A. Chronic lymphocytic leukemia in Ethiopians. East-Afr Med. J. 1996; 73: 643-46.
- Fleming AF. Leukemias in AFRICA. Leukemia 1993; 7: S138- 141.
- Vyas N, Hasssan A. Recent advances in chronic lymphoid leukemia. Indian J Cancer 2012; 49: 139-43.
- Dighiero G, Travade P, Chevret S, Fenaux P, Chastang C, Binet JL. B-cell chronic lymphocytic leukemia: present status and future directions. French Cooperative Group on CLL. Blood 1991; 78:1901-14.
- Berman E, Heller G, Kempin S, Gee T, Tran LL, Clarkson B. Incidence of response and long-term follow up in patients with hairy cell leukemia treated with recombinant interferon alpha-2a. Blood 1990;75: 839-45.
- Bouroncle BA, Wiseman BK, Doan CA. Leukemic reticuloendotheliosis. Blood 1958;13:609-30.
- Clavel J, Flandrin G. Epidémiologie des leucémies à tricholeucocytes. Hématologie 1999 ;5:295-9.
- Haglund U, Julliusson G, Stellan R, Gahrton G. Hairy cell leukemia is characterized by clonal chromosome abnormalities clustered to specific regions. Blood 1994;83: 2637-45.
- Jaiyesimi I, Kantarjian H, Estey E. Advances in therapy for hairy cell leukemia. A review. Cancer 1993;72:5-16.
- Semedby KE, Hjalgrin H. Epidemiology and etiology of mantle cell lymphoma and other non Hodgkin lymphoma subtypes. Semin Cancer Biol. 2011; 21: 293-98
- T Lamy, M Hamidou, T Loughran Jr. Spectre des proliférations LGL et nouveaux concepts physiopathogéniques. Hématologie 1999 ; 5 : 300-8.
- Diamandidou E , Cohen PR, Kurzork R. Mycosis fungoides and Sezary syndrome. Blood 1996; 88: 2385-409.
- Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J. Lymphoma classification--from controversy to consensus: the R.E.A.L. and WHO Classification of lymphoid neoplasms. Ann Oncol 2000; 1: 3-10.
- Garrido P, Jimenez P, Sanchez C et al. Molecular and Flow Cytometry Characterization During the Follow-up of three Simultaneous Lymphoproliferative disorders: Hairy Cell Leukemia, Monoclonal B-Cell Lymphocytosis, and CD4+/CD8+/-dim T-Large Granular Lymphocytosis—A Case Report. Cytometry B Clin Cytom 2011; 80:195-200.