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Published on: March 29, 2017
Immunophenotypic profile of lymphoplasmacytic lymphoma/Waldenström macroglobulinemia
Sergej Konoplev1, L Jeffrey Medeiros, Carlos E Bueso-Ramos
1Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Insights
Flow cytometry reveals variable immunophenotypes in lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM). Common markers include CD19, CD20, and CD52, with CD23 and CD11c frequently expressed.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM) is a distinct B-cell lymphoproliferative disorder.
- Accurate immunophenotyping is crucial for diagnosis and differentiating LPL/WM from other B-cell malignancies.
Purpose of the Study:
- To retrospectively analyze the immunophenotypic profile of LPL/WM cases using flow cytometry.
- To identify common and variable antigen expression patterns in LPL/WM.
Main Methods:
- Retrospective review of 75 LPL/WM cases.
- Flow cytometry analysis of neoplastic cells for various surface and cytoplasmic antigens.
- Correlation of immunophenotype with clinical diagnosis of WM and monoclonal IgM levels.
Main Results:
- All cases expressed monoclonal immunoglobulin light chain, CD19, CD20, and CD52.
- High positivity rates observed for surface IgM (93%), CD79b (85%), CD11c (81%), and CD25 (71%).
- CD23 (61%) and CD11c (81%) were commonly expressed, often at dim intensity; rare CD5+ and CD10+ cases were noted.
Conclusions:
- The immunophenotype of LPL/WM is diverse and can overlap with other B-cell lymphoproliferative disorders.
- CD23 and CD11c are frequently expressed in LPL/WM, aiding in diagnosis.
- The study highlights the heterogeneity of LPL/WM immunophenotypes.
Abstract:
We retrospectively reviewed the immunophenotypic profile of 75 cases of lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM) analyzed by flow cytometry. All patients had monoclonal IgM (median, 2,100 mg/dL [21 g/L]) in serum and were considered clinically to have WM. The neoplastic cells, in all cases, expressed monoclonal immunoglobulin light chain (k, 55; l, 20) and CD19, and every case assessed was positive for CD20 (n=68) and CD52 (n=60). The results for other antigens assessed in decreasing frequency of positivity were as follows: surface IgM (26/28 [93%]), CD79b (11/13 [85%]), CD11c (13/16 [81%]), CD25 (5/7 [71%]), CD23 (17/28 [61%]), CD38 (24/50 [48%]), FMC7 (11/29 [38%]), CD22 (4/12 [33%]), CD5 (3/65 [5%]), and CD10 (1/38 [3%]). These results show that the immunophenotype of LPL/WM is variable and overlaps with other B-cell lymphoproliferative disorders. CD23, usually of dim intensity, and CD11c are expressed commonly in LPL/WM. Rare CD5+ and CD10+ cases of LPL/WM also exist.
