Diagnostic application of two-color flow cytometry in 161 cases of hairy cell leukemia

Robbins, Bruce A.; Ellison, Douglas J.; Spinosa, John C.; Carey, Cristin A.; Lukes, Robert J.; Poppema, Sibrand; Saven, Alan; Piro, Lawrence D.

doi:10.1182/blood.v82.4.1277.1277

Cited by 169 publications

(31 citation statements)

References 41 publications

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“…The CD20 and CD22 antigen numbers on normal B cells estimated in our experiment are reflecting the heterogeneities of values obtained in previous studies ( Table 5). The number of CD22 molecules on CLL cells, estimated both as MESF and ABC QSC , is below 20% that of normal control donor B cells, which is in line with the published data (14,16).…”

Section: Discussionsupporting

confidence: 91%

“…Moreover, a unimodal distribution rather than discrete populations of positive and negative cells introduces a certain degree of variation in interpretation of the frequency distributions of CD19, CD20, and CD22 antigens on leukemia cells. Various scoring systems have been proposed based on ''semiquantitative'' immunophenotypic analysis for the distinction between CLL and other B-cell lymphoproliferative disorders (6,15,16). High sIgM fluorescence intensities were found to correlate with shorter survival (17).…”

Section: Introductionmentioning

confidence: 99%

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Performance of calibration standards for antigen quantitation with flow cytometry in chronic lymphocytic leukemia

Rossmann

Lenkei

Lundin

et al. 2007

Cytometry Part B Clinical

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Background: The fluorescence intensities of CD3, CD4 on T cells and CD20, CD22 molecules on B cells were quantitatively measured on lymphocytes from chronic lymphocytic leukemia (CLL) patients and healthy donors.Methods: The performance of three different types of microbeads was compared, i.e. Quantum molecules of equivalent soluble fluorochrome (Q-MESF), Quantum simply cellular (QSC), and QuantiBRITE TM (QB). As all PE-conjugates had a F/P ratio of 1:1, the MESF units represented also the antibody binding capacity (ABC).Results: The ABCs of CD4 and CD20 antigens estimated with QSC (ABC QSC ) were higher than those assigned with QB (ABC QB ) with an average difference 49%. Higher numbers of antigenic sites were obtained with Q-MESF than with QSC for CD20 antigen. On the contrary, CD4 antigenic sites numbers estimated with QSC were higher than those estimated with Q-MESF. ABC values estimated with Quantum MESF PE (ABC Q-MESF ) were *15% higher than ABC QSC , whereas ABC Q-MESF was *49% higher than ABC QB INTRODUCTIONQuantitative measurements of fluorescence intensity by flow cytometry (QFCM) assess the numbers of monoclonal antibody (mAb) molecules bound to a cell. The fluorescence intensity (FI) of staining correlates to the number of fluorochrome conjugated mAb molecules bound to the cell, and consequently, the amount of receptors on the cell. Thus, the number of antigen receptors can be determined by QFCM, through estimation of the exact numbers of bound fluorescent antibody molecules, provided that appropriate standards and fluorescence controls are tested in parallel and reagents in saturating amounts are used. In addition, the process of quantitation facilitates standardization and quality control (1).

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Performance of calibration standards for antigen quantitation with flow cytometry in chronic lymphocytic leukemia

Rossmann

Lenkei

Lundin

et al. 2007

Cytometry Part B Clinical

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“…Occasionally, atypical variants of HCL can cause diagnosis problems. In a study including 161 cases of HCL, HCL cells typically expressed a uniform and unique B-cell phenotype, with positive staining for B-ly7, very intense, uniform expression of CD11c, moderately intense staining for CD25, very intense staining for CD22, moderate to very intense staining for CD20, and moderately intense monoclonal surface Ig (Robbins et al, 1993). In this report we demonstrated that SLVL cells expressed DBA44 in 71% of cases, a marker which recognizes over 98% of HCL (Hounieu et al, 1991).…”

Section: Discussionmentioning

confidence: 99%

Splenic lymphoma with villous lymphocytes: clinical presentation, biology and prognostic factors in a series of 100 patients

et al. 1996

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The diagnosis of splenic lymphoma with villous lymphocytes (SLVL) was assessed by a panel of cytologists in a series of 100 patients. Clinical and biological characteristics were analysed in relation to prognosis. SLVL is a chronic B-cell lymphoproliferative disorder characterized by splenomegaly and the presence, in peripheral blood, of lymphocytes with "villous' projections. The cytological diagnosis can be difficult in patients without an absolute lymphocytosis which was observed in 24% of cases. B-cells expressed CD19+, CD20+, CD22+, CD24+ and DBA44+, whereas the expression of CD5, CD10 and CD25 was usually negative. SLVL is a disease of the elderly with a relatively benign clinical course. In the present series the 5-year overall survival was 78%. Deaths in 15 patients were related to disease progression or treatment (nine cases). Patients with a leucocyte count > 30 x 10(9)/1 or lymphocyte count < 4 x 10(9)/1 or initially treated with chemotherapy had significantly (P < 0.001) lower overall survival than other patients. From these findings, treatment abstention should be considered in patients with favourable prognostic factors; on the other hand, the efficacy of conventional chemotherapy remains to be evaluated in patients with unfavourable prognostic factors.

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“…However, the significance of this finding is still uncertain as there was no direct correlation between the presence of residual disease and relapse despite long-term follow-up of most patients. The distinct marker profile of hairy cells, strong CD22, CD11c þ , CD25 þ , HC2 þ and CD103 þ makes immunophenotyping suitable for detecting MRD or monitoring treatment either by double immunostaining with flow cytometry (Robbins et al, 1993) or by simultaneous assessment of the morphology and the staining with a McAb in peripheral blood and/or bone marrow trephines. Our findings have shown that in patients with active HCL, immunophenotyping is more sensitive than morphology alone for the identification of circulating hairy cells as disease could be detected in the blood from almost all cases whilst hairy cells could not be identified in one third of smears.…”

Section: Discussionmentioning

confidence: 99%

The significance of minimal residual disease in hairy cell leukaemia treated with deoxycoformycin: a long‐term follow‐up study

et al. 1997

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Summary.We investigated the clinical significance and long-term follow-up of detecting minimal residual disease (MRD) in hairy cell leukaemia (HCL) in complete remission (CR) after treatment with deoxycoformycin (DCF). MRD was assessed in 23 patients by immunophenotyping peripheral blood and bone marrow frozen sections using a panel of antibodies, CD11c, CD25, CD103 and HC2, which detect hairy cells. 31 cases with active HCL were used as controls. 10/23 patients (43%) had MRD in bone marrow (seven), blood (one) or both sites (two) which was not detected on haematoxylin-eosin bone marrow sections nor by immunohistochemistry on paraffin sections in six cases tested. Sequential studies in four cases did not show changes in the amount of MRD. At a median follow-up of 72 months (range 15-108), 5/23 (22%) patients have relapsed with a median time of 59 months (range 15-105). MRD was detected in three of the five patients who relapsed. In the two patients with negative MRD, one relapsed with an abdominal mass and the other was a late relapse at 84 months. MRD was also documented in 7/18 patients who continued in clinical CR for a median of 80 months (range 63-98). There were no statistical differences in disease-free survival between MRD þ and MRD ¹ patients (P ¼ 0 . 8). Our findings indicate that relapse after long-term remission achieved with DCF cannot be predicted when MRD is detected by sensitive methods. A search for other parameters such as proliferative rate of the residual cells or chest and abdominal CT scan might identify patients with a higher probability of disease recurrence.

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Diagnostic application of two-color flow cytometry in 161 cases of hairy cell leukemia

Cited by 169 publications

References 41 publications

Performance of calibration standards for antigen quantitation with flow cytometry in chronic lymphocytic leukemia

Performance of calibration standards for antigen quantitation with flow cytometry in chronic lymphocytic leukemia

Splenic lymphoma with villous lymphocytes: clinical presentation, biology and prognostic factors in a series of 100 patients

The significance of minimal residual disease in hairy cell leukaemia treated with deoxycoformycin: a long‐term follow‐up study

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