Abstract
BackgroundFlow cytometry (FC) is a popular method to detect bone marrow (BM) involvement in patients with B-cell non-Hodgkin lymphoma (B-NHL). The majority of screen panels of FC still rely on finding monoclonal B-cells, e.g., B-cells with immunoglobin (Ig) light-chain restriction, which has many limitations. Therefore, exploring new markers is warranted.MethodsA total of 52 cases of B-NHL with BM involvement were collected. The median age was 60 years. Out of these 52 cases, 34 were male, and 18 were female. A 10-color FC panel was used to detect the expression of CD54 on lymphoma cells. The expression of CD54 was calculated as the mean fluorescence index ratio (MFIR) and was described as the mean ± standard error of the mean (SEM).ResultsUp to 18/52 (34.62%) of BM specimens abnormally expressed an increased level of CD54, including 1/10 cases of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), 9/13 cases of mantle cell lymphoma (MCL), 2/14 cases of follicular lymphoma (FL), 5/9 cases of marginal zone lymphoma (MZL), and 1/3 cases of high-grade B-NHL (HG B-NHL). The expression level of CD54 was significantly increased in MCL cases (53.41 ± 11.04) compared with CLL/SLL cases (11.66 ± 2.79) and FL cases (13.49 ± 2.81). The lowest percentage of CD54-positive B-cells attained 0.13%. In 5/9 cases of MZL and 1/3 cases of HG B-NHL, increased expression of CD54 was the only abnormal immunophenotype detected besides Ig light-chain restriction. No aberrant CD54 expression was identified by FC in lymphoplasmacytic lymphoma (LPL) (0/2) and Burkitt lymphoma (BL) (0/1) cases. Aberrant expression of CD54 was not related to plasma cell differentiation.ConclusionLymphoma cells, especially in MCL and MZL cases, frequently show increased expression of CD54. Such aberrant expression is not related to plasma cell differentiation. We highly recommend adding CD54 to the FC screening panel to detect BM involvement in patients with B-NHL.
Highlights
Flow cytometry (FC) is a popular method to detect bone marrow (BM) involvement in patients with B-cell non-Hodgkin lymphoma (B-Non-Hodgkin lymphoma (NHL))
The BM results of B‐NHL cases with BM involvement In 39/52 B-cell non-Hodgkin lymphoma (B-NHL) cases, BM involvement was confirmed by BM biopsies
In the BM specimens of the 52 B-NHL cases, the median lymphocytes number collected by flow cytometer was 23,061 (1127 – 318,940), which was considered adequate for FC analysis
Summary
Flow cytometry (FC) is a popular method to detect bone marrow (BM) involvement in patients with B-cell non-Hodgkin lymphoma (B-NHL). Involvement of bone marrow (BM) by B-cell non-Hodgkin lymphoma (B-NHL) is correlated with poor outcomes [1,2,3,4,5]. Flow cytometry (FC) is a rapid, In FC, the hallmark of B-NHL diagnosis is the presence of monoclonal B-cells, which can be detected as immunoglobulin (Ig) light-chain restriction. Ig light-chain restriction, is a nonspecific phenomenon; it presents in reactive/ benign B-cell proliferation [13,14,15,16,17,18]. On that account, exploring novel markers to distinguish between reactive/benign mature B-cells and lymphomatous B-cells is crucial
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