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Flow-sorting and Exome Sequencing of the Reed-Sternberg Cells of Classical Hodgkin Lymphoma
Published on: June 10, 2017
Immunophenotypic variability of B-cell non-Hodgkin lymphoma: a retrospective study of cases analyzed by flow
Carolina Echeverri1, Stephen Fisher, David King
1Department of Pathology, University of Texas Health Science Center, San Antonio, USA.
Insights
Flow cytometry antigen expression in non-Hodgkin lymphoma can vary between specimens. Some antigens like CD19 and CD20 are stable, while others like CD21 and CD22 show variability, impacting diagnosis and treatment.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Flow cytometry is crucial for diagnosing and monitoring non-Hodgkin lymphoma.
- Consistent lymphoma phenotype across specimens is generally assumed for patient management.
Purpose of the Study:
- To investigate the variability of lymphoid antigen expression in non-Hodgkin lymphoma specimens.
- To identify antigens with stable versus variable expression patterns.
Main Methods:
- Retrospective review of 211 flow cytometry specimens from 81 non-Hodgkin lymphoma patients.
- Analysis of expression patterns for various lymphoid antigens.
Main Results:
- Antigens CD5, CD10, CD19, CD20, and HLA-DR demonstrated stable expression.
- Antigens CD21, CD22, CD23, and CD25 exhibited significant variability between specimens.
- Biological function and standardization of flow cytometry procedures were identified as factors influencing antigen stability.
Conclusions:
- Lymphoid antigen expression in non-Hodgkin lymphoma is not always stable across specimens.
- Variability in antigens like CD22 may relate to B-cell activation roles.
- Standardization of flow cytometry protocols is essential for accurate interpretation.
Abstract:
Flow cytometric analysis is important in the diagnosis, classification, and follow-up of non-Hodgkin lymphoma. It is assumed that the lymphoma phenotype for each patient remains unchanged over time and is consistent from one specimen to another. To determine the variability in expression of lymphoid antigens, we reviewed 211 flow cytometry specimens of malignant lymphoma from 81 patients. Some antigens showed a stable pattern of expression such as CD5, CD10, CD19, CD20, and HLA-DR. In contrast, CD21, CD22, CD23, and CD25 showed more variability from one specimen to another. We believe several factors affect the stability of antigen expression. True differences in expression most probably are related to the biology and function of the different antigens. For instance, CD19 and CD20 are essential in cell maturation and function and, therefore, are present on the majority of cells. In contrast, CD22 has a role during B-cell activation and, therefore, is more variable. Lack of standardization inflow cytometry procedures also is responsible for some variability. Instrument settings for adequate compensation and the criteria used to determine when an antigen is reported as positive are important considerations when evaluating flow cytometry histograms.
