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Published on: October 19, 2014
Analysis of chronic lymphoid leukaemias according to FAB
1Hämatologische Abteilung im Klinikum R. Virchow-Charlottenburg, Freien Universität Berlin, Germany.
Insights
Immunophenotyping aids in diagnosing chronic lymphoid leukaemias (CLL) but morphology remains crucial. Specific markers like HML1 help identify hairy cell leukaemia (HCL), while CD5 and CD22s have limited value for differentiating B-CLL subtypes.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Chronic lymphoid leukaemias (CLL) encompass a heterogeneous group of B-cell malignancies.
- Accurate classification is essential for prognosis and treatment.
- The French-American-British (FAB) classification system provides a framework for diagnosing leukaemias.
Purpose of the Study:
- To investigate the immunophenotypic features of various chronic lymphoid leukaemias.
- To assess the utility of immunophenotyping in classifying leukaemias according to FAB guidelines.
- To identify specific immunophenotypic markers for different CLL subtypes.
Main Methods:
- Immunophenotyping of mononuclear blood leukocytes using the alkaline phosphatase-antialkaline phosphatase (APAAP) method.
- Analysis of 114 leukaemia cases, including B-chronic lymphocytic leukaemia (B-CLL) and other lymphoid leukaemias.
- Evaluation of antibody reactivity, including HML1, CD11c, CD25, CD5, and CD22s.
Main Results:
- 111 out of 112 B-chronic lymphoid leukaemias showed monotypic light chains.
- HML1 antibody was highly specific for hairy cell leukaemia (HCL).
- CD5 positivity and CD22s negativity were common in B-CLL, B-CLL/PL, and mixed-type B-CLL, but lacked specificity for differentiation.
Conclusions:
- Morphological study of leukaemic cells is the most valuable diagnostic basis for chronic lymphoid leukaemias.
- Immunophenotyping has value in diagnosing specific cases but limited utility for broad classification of CLL subtypes.
- FAB classification may not encompass all observed chronic lymphoid leukaemias.
Abstract:
We have studied the immunophenotypic features in patients with chronic lymphoid leukaemia and investigated the suitability of classification according to guidelines of the French-American-British (FAB) group. Immunophenotyping was carried out on cytocentrifuge preparations of mononuclear blood leukocytes using the alkaline phosphatase-antialkaline phosphatase (APAAP) method. The 114 leukaemias, including 58 cases of B-chronic lymphocytic leukaemia (B-CLL), 3 Waldenström's macroglobulinaemia, 6 prolymphocytic leukaemia (B-PL), 13 B-CLL/PL, 4 B-CLL of mixed cell type, 8 splenic lymphoma with villous lymphocytes (SLVL), 8 hairy cell leukaemia (HCL), two HCL variant, three leukaemic phase of follicular lymphoma, two leukaemic phase of intermediate lymphoma, two plasma cell leukaemia and two chronic T-cell leukaemia, were investigated. The 111 of 112 B-chronic lymphoid leukaemias (B-CLL + B-PL + B-CLL/PL + SLVL + HCL etc.) showed monotypic light chains. The antibody HML1 was highly specific for HCL. The antibodies CD11c and CD25 were positive in all HCL cases, but were not specific for this disease. CD5 positivity and CD22s negativity were found in most patients with B-CLL, B-CLL/PL and B-CLL of mixed type. This marker type has a limited value for differentiation from the other chronic lymphoid leukaemias. We also studied three patients with chronic lymphoid leukaemia which were not described by the FAB classification. We conclude that a study of the morphology of the leukaemic cells was the most useful basis for the diagnosis of these leukaemias, whereas immunotyping was apparently valuable only in individual cases.
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