Immunocytochemical Detection of BCL-2 Protein in Chronic B-Cell Lymphoproliferative Disorders

Background: The expression of anti-apoptotic B-cell lymphoma 2 (BCL-2) protein in B-cell chronic lymphoproliferative disorders (B-CLPDs) can provide valuable prognostic information and assist in assessing minimal bone marrow (BM) infiltration. This study aimed to detect BCL-2 expression in B-CLPDs and correlate the findings with various clinicobiologic factors. Materials and Methods: Immunocytochemical staining was performed on mononuclear cell smears from 46 Sudanese patients, including 25 with B-cell chronic lymphocytic leukaemia (B-CLL) and 21 with B-cell non-Hodgkin's lymphomas (B-NHL), who were enrolled during their visit to the Radiation and Isotope Centre and Fedail Hospital, Khartoum. Diagnosis was based on clinical examination, morphology, and immunophenotyping. Results: Among the 46 B-CLPD cases, BCL-2 expression was identified in 13 (28.2%), including 8/25 (32%) cases with B-CLL and 5/21 (23.8%) with B-NHL. No statistically significant associations were found between BCL-2 expression and age, sex, total white blood cell count, disease stage, and serum lactate dehydrogenase levels (all P>0.05). However, BM involvement was significantly associated with BCL-2 expression (P=0.02). Conclusion: The immunocytochemical staining method effectively detects BCL-2 protein in B-CLPDs, even in cases with minimal BM infiltration, thereby facilitating the correlation of this protein's expression with morphological and other clinicobiologic features. By combining cytologic morphology with immunocytochemistry, this technique enables earlier and more accessible evaluation of BM involvement.