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Updated: Aug 10, 2026
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Published on: April 16, 2013
Discordant immunophenotype of chronic B-cell lymphoproliferative disorders in simultaneous specimens from bone marrow
Y C Liu1, R P Cleveland, C Madelaire
1Department of Pathology, MetroHealth Medical Center, Cleveland, OH 44109.
Insights
Chronic B-cell lymphoproliferative disorders can show different cell markers in bone marrow versus peripheral sites. Bone marrow testing is crucial for identifying myeloid markers linked to aggressive disease progression.
Area of Science:
- Hematology
- Oncology
- Immunophenotyping
Background:
- Chronic B-cell lymphoproliferative disorders (B-CLPD) are a group of hematologic malignancies.
- Accurate diagnosis and prognosis rely on detailed immunophenotypic analysis.
Purpose of the Study:
- To investigate discordant immunophenotypes in B-CLPD between bone marrow and peripheral sites.
- To determine the clinical significance of myeloid-associated marker expression in these disorders.
Main Methods:
- Simultaneous bone marrow and peripheral blood specimens from 10 B-CLPD patients were analyzed.
- Flow cytometric immunophenotyping was performed to assess cell surface markers.
- Clinical data, including Rai's stage and disease progression, were correlated with immunophenotype.
Main Results:
- All peripheral site samples showed monoclonal B-cell proliferation.
- Eighty percent of cases exhibited discordant immunophenotypes, with myeloid markers (CD13, CD11b, CD15) detected only in bone marrow.
- Myeloid marker expression in bone marrow correlated with advanced disease and aggressive clinical course.
Conclusions:
- Discordant immunophenotypes are common in B-CLPD between different anatomical sites.
- Bone marrow examination is essential for detecting myeloid-associated markers, which may indicate a poorer prognosis.
- Targeted analysis of bone marrow specimens is recommended for comprehensive assessment of B-CLPD.
Abstract:
This study consisted of 10 cases of chronic B-cell lymphoproliferative disorders that had simultaneous specimens obtained from both bone marrow and peripheral sites for flow cytometric immunophenotyping. The immunophenotyping results of peripheral sites from all 10 cases showed a monoclonal B-cell proliferation expressing monoclonal surface immunoglobulin, CD19, CD20, HLA-DR, and CD5 (except 1 case). Eight (80%) of the 10 cases, however, demonstrated discordant immunophenotypes with myeloid-associated marker expression (CD13, CD11b, and/or CD15) found only in the bone marrow. Patients with CD13 or CD11b marker expression in the bone marrow followed an aggressive clinical course with advanced Rai's stage and a diffuse or mixed bone marrow infiltration pattern or disease transformation. These results indicate that discordant immunophenotypes of malignant cells from different body sites occur in chronic B-cell lymphoproliferative disorders and are not uncommon. Additionally; myeloid-associated markers, which some investigators have described as being associated with an unfavorable clinical course, may be expressed only in bone marrow specimens in these disorders. Thus, bone marrow specimens may be preferential in determining myeloid-associated marker expression in chronic B-cell lymphoproliferative disorders.
