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Hairy cell leukemia. Diagnosis of bone marrow involvement in paraffin-embedded sections with monoclonal antibody
H Hounieu1, S M Chittal, T al Saati
1Anatomical Pathology Department of CHU-Purpan, Toulouse, France.
Insights
A new antibody, DBA.44, identifies a B-cell antigen on hairy cell leukemia cells. This antibody aids in diagnosing hairy cell leukemia and monitoring treatment effectiveness in bone marrow biopsies.
Area of Science:
- Hematopathology
- Immunology
- Oncology
Background:
- B-cell differentiation antigens play crucial roles in lymphocyte identification.
- Accurate diagnosis of hematologic malignancies is essential for effective treatment.
- Hairy cell leukemia (HCL) is a rare B-cell leukemia requiring specific diagnostic markers.
Purpose of the Study:
- To characterize the reactivity of the novel monoclonal antibody DBA.44.
- To evaluate the utility of DBA.44 in diagnosing hairy cell leukemia.
- To assess DBA.44's potential in distinguishing HCL from other B-cell lymphomas.
Main Methods:
- Immunohistochemical staining of routinely fixed and decalcified bone marrow biopsy specimens.
- Analysis of 166 patients with hairy cell leukemia.
- Comparative analysis with other B-cell lymphomas and chronic lymphocytic leukemia.
Main Results:
- DBA.44 recognizes a fixation-resistant B-cell differentiation antigen.
- Strong positive staining observed on the 'hairy' features of leukemic cells in nearly all HCL cases.
- DBA.44 effectively distinguished HCL from B-cell chronic lymphocytic leukemia and other lymphomas.
Conclusions:
- DBA.44 is a valuable diagnostic tool for confirming hairy cell leukemia.
- The antibody aids in estimating HCL bone marrow burden pre- and post-treatment.
- DBA.44 assists in diagnosing ambiguous cases of hairy cell leukemia in diagnostic hematopathology.
Abstract:
The new monoclonal antibody DBA.44 recognizes an unknown fixation-resistant B-cell differentiation antigen expressed by mantle zone lymphocytes, reactive immunoblasts, monocytoid B cells, and a small proportion of high- and low-grade lymphomas. Among node-based lymphomas, the strongest membrane staining was observed in centroblastic, immunoblastic, and monocytoid B-cell lymphomas. In studying bone marrow biopsy specimens from 166 patients with hairy cell leukemia, strong positive staining of surface membrane 'hairy' features of leukemic cells was observed in routinely fixed and decalcified bone marrow biopsy specimens of nearly all cases. The antibody distinguished hairy cell leukemia from the more common B-cell chronic lymphocytic leukemia and bone marrow infiltrates of typical lymph node-based lymphomas by immunomorphologic criteria. DBA.44 was valuable to (1) confirm the diagnosis of hairy cell leukemia, (2) estimate the bone marrow density of hairy cell leukemia before and after treatment, and (3) make the diagnosis of hairy cell leukemia in ambiguous cases, which are all properties that indicate its usefulness in the practice of diagnostic hematopathology.
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