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CD5+ immunophenotype in the bone marrow but not in the peripheral blood in a patient with hairy cell leukemia
1Section of Hematology-Oncology, University of Illinois at Chicago, 60607-7173, USA. ushalyd@uic.edu
Insights
This study details a rare case of CD5+ hairy cell leukemia with differing immunophenotypes in bone marrow and blood. The patient achieved complete remission with cladribine, showing the CD5+ status did not alter prognosis or treatment response.
Area of Science:
- Hematology
- Oncology
- Immunophenotyping
Background:
- Hairy cell leukemia (HCL) is a rare B-cell chronic lymphoid leukemia.
- The typical immunophenotype includes CD19+, CD20+, CD25+, and CD123+ expression.
- CD5 expression is uncommon in HCL.
Observation:
- A rare case of CD5+ hairy cell leukemia is presented.
- An unusual discrepancy in immunophenotypes was observed between the patient's bone marrow and peripheral blood.
- CD5+ cells were predominant in the bone marrow, while CD5- cells were more prevalent in peripheral blood.
Findings:
- The immunophenotypic discrepancy is attributed to clonal maturation and preferential homing of CD5- cells to the periphery.
- The patient received standard cladribine (2'-chlorodeoxyadenosine) therapy.
- Complete remission was achieved following cladribine treatment.
Implications:
- The CD5+ immunophenotype in HCL does not appear to impact prognosis.
- Standard cladribine therapy remains effective for HCL regardless of CD5 expression.
- This case highlights the importance of considering clonal heterogeneity and maturation in interpreting immunophenotypic findings in HCL.
Abstract:
We report the case of a patient with rare CD5+ hairy cell leukemia, which was unusual, as there was also a discrepancy between the bone marrow and peripheral blood immunophenotypes. We propose that some degree of maturation within the malignant clone and the predominance of more mature CD5- hairy cells in the peripheral blood can explain this observation. The patient was treated with a conventional course of cladribine (2'-chlorodeoxyadenosine) and achieved complete remission. We conclude that the unusual CD5+ immunophenotype of this patient did not affect prognosis or change the response to standard therapy.
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