[Bone marrow immunophenotypes of 112 cases of lymphoid system malignant diseases].

BACKGROUND & OBJECTIVE: Diagnosis of lymphocytic leukemia and non-Hodgkin's lymphoma (NHL) is based on bone marrow morphology. Immunophenotyping will make diagnosis more precise through analyzing the origin and differentiation status of tumor, which is necessary for treatment and prognosis prediction. This study was to analyze the immunophenotypic characteristics of lymphocytic leukemia and NHL with bone marrow involvement using flow cytometry (FCM).

METHODS: Bone marrow specimens from 112 patients with lymphocytic leukemia or NHL with bone marrow involvement were detected by FCM using antibodies of T, B and myeloid cell series. Using CD45/SSC gating strategy, the samples were analyzed with 5 parameters (FSC, SSC, McAb1-FITC, McAb2-PE, CD45-cytochrome).

RESULTS: In 45 cases of precursor B lymphoblastic leukemia/lymphoma (B-ALL/LBL), the antigens were mainly CD19, CD10, TdT, CD34, HLA-DR, and CD20. In 32 cases of precursor T lymphoblastic leukemia/lymphoma (T-ALL/LBL), the antigens were mainly CD7, CD5, cytoplasmic (Cy)CD3, TdT, CD34, surface CD3 (sCD3), and HLA-DR. Of the 77 cases of precursor ALL/LBL, 28(36.4%) expressed myeloid-associated antigens, such as CD13 and CD33; 9 (20.0%) cases of B-ALL/LBL coexpressed CD20 and CD34; 28(87.5%) cases of T-ALL/LBL coexpressed cyCD3 and TdT. Among the 35 cases of mature B-cell malignancies, 17 cases of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) mainly expressed CD19, CD20, CD5, HLA-DR, with coexpression of CD19 and CD5; 4 cases of diffuse large B-cell lymphoma (DLBCL) mainly expressed CD19, CD20, CD10, and HLA-DR; 3 cases of Burkitt's lymphoma (BL) mainly expressed CD19, CD10, CD20, and sIgM; 1 case of mantle cell lymphoma (MCL) expressed CD5, CD19, CD20, and HLA-DR. Among the 10 mature T-cell malignancies, 5 cases of unspecialied peripheral T-cell lymphoma (PTCL) mainly expressed sCD3, CD5 and CD7, CD4 or CD8; 1 case of anaplastic large cell lymphoma (ALCL) expressed sCD3 and HLA-DR; 4 cases of NK/T-cell malignancies expressed CD56 and HLA-DR, CD4 or CD8 or CD7. Mature lymphoid system malignancies didn't express early antigens, such as CD34 and TdT, but expressed myeloid-associated antigens, especially CD13 and CD33.

CONCLUSION: Multiparameter FCM can not only provide data of cell lineage and differentiation status but also detect phenotypic aberrancies, which is helpful for minimal residual disease detecting.