Abstract:
Multicolor flow cytometry (MFC) is crucial in detecting occult or minimal bone marrow (BM) involvement by non-Hodgkin lymphomas (NHL), which may not be detected using trephine biopsy or imaging studies. Detection of low-level BM involvement can be challenging without definite immunophenotypic aberrancies. We studied the utility of CD305 in MFC detection of minimal BM involvement by B-NHL, especially in the absence of aberrancies by commonly used markers. The study included 1084 consecutive BM samples submitted for the staging of B-NHLs (excluding CLL) over two years. Samples were studied for morphological, immunophenotypic, and histopathological assessment. MFC studies were performed using 10-13 color MFC, including CD305-antibody (clone, DX26). Minimal BM involvement was defined with a cutoff of ≤10% lymphoma cells in viable cells on MFC assessment. Of 1084, 148 samples revealed overt morphological involvement by B-NHL and were excluded from analysis. BM samples of 172/936 patients were morphologically negative but revealed involvement using MFC independently. Corresponding trephine biopsy involvement was detected in only 79/172 (45.9%) patients. On MFC, 23/172 samples showed BM involvement with >10% lymphoma cells, and 149/172 (86.6%) samples revealed minimal involvement. In 54/149 (36.24%) samples, lymphoma cells were detected only with aberrant loss of CD305 expression. In 78 of the remaining 95 samples (82.1%), it provided an immunophenotypic aberrancy addition to other markers and supported the results. CD305 is a highly useful marker in the flow cytometric assessment of minimal BM involvement by B-NHL. MFC is a superior modality to trephine biopsy in detecting low-level BM involvement.
摘要:
多色流式细胞术(MFC)在检测非霍奇金淋巴瘤(NHL)隐匿性或轻度骨髓(BM)受累中至关重要,使用环钻活检或影像学检查可能无法检测到。在没有明确的免疫表型异常的情况下,低水平BM参与的检测可能具有挑战性。我们研究了CD305在B-NHL最小BM参与的MFC检测中的实用性,特别是在常用标记没有异常的情况下。该研究包括在两年内提交的1084个连续的BM样本,用于B-NHL(不包括CLL)的分期。样品进行了形态学研究,免疫表型,和组织病理学评估。MFC研究使用10-13色MFC进行,包括CD305-抗体(克隆,DX26).在MFC评估中,以存活细胞中淋巴瘤细胞≤10%的截止值定义最小BM参与。在1084个样本中,有148个样本显示出B-NHL明显的形态学参与,并被排除在分析之外。172/936例患者的BM样本在形态上为阴性,但使用MFC独立显示受累。仅在79/172(45.9%)患者中检测到相应的环钻活检受累。在MFC上,23/172样本显示BM受累>10%淋巴瘤细胞,和149/172(86.6%)的样本显示最小的参与。在54/149(36.24%)样本中,仅在CD305表达异常缺失的情况下检测到淋巴瘤细胞。在其余95个样本中的78个(82.1%),它提供了对其他标志物的免疫表型异常,并支持了结果。CD305在B-NHL的最小BM参与的流式细胞术评估中是非常有用的标志物。在检测低水平BM受累方面,MFC是一种优于环钻活检的方式。