Bright CD38 Expression by Flow Cytometric Analysis Is a Biomarker for Double/Triple Hit Lymphomas with a Moderate...

Area of Science:

• Hematology
• Oncology
• Flow Cytometry

Background:

• High-grade B-cell lymphomas (HGBCL) with MYC and BCL2 or/and BCL6 rearrangements (DH/THL) are aggressive and require rapid diagnosis.
• Identifying reliable immunophenotypic (IP) features can expedite DH/THL diagnosis.

Purpose of the Study:

• To identify flow cytometric IP features of DH/THL that can aid in triaging cases for timely cytogenetic confirmation.
• To evaluate CD38 expression as a potential biomarker for DH/THL.

Main Methods:

• Compared IP features of 43 DH/THL cases with 55 single-hit lymphoma (SHL) and 59 MYC-negative diffuse large B-cell lymphoma (DLBCL) cases.
• Analyzed expression patterns of CD10, CD19, CD20, CD38, and surface immunoglobulin light chain.

Main Results:

• Bright CD38 expression (CD38^bright) was more frequent in DH/THL (56%) than MYC-negative DLBCL (17%), but less frequent than in SHL (82%).
• CD38^bright demonstrated moderate sensitivity (~50%) and high specificity (~90%) for DH/THL.
• Very bright CD38 expression was exclusive to MYC-rearranged lymphomas.

Conclusions:

• CD38^bright is a valuable biomarker associated with DH/THL, aiding in diagnosis and prioritizing FISH testing.
• While not a standalone screening tool, CD38^bright can expedite diagnosis in resource-limited settings.
• Further research combining CD38 with immunohistochemical markers may enhance predictive power for DH/THL.