Morphological and immunofenotypic features of the monoclonal population of B-lymphocytes in chronic lymphocytic leukemia

Abstract

Purpose of the study. To evaluate the features of morphological and immunophenotypic characteristics of the lymphoid population with different restriction of light chains of immunoglobulins in patients with chronic lymphocytic leukemia (CLL).Materials and methods. The study included 30 CLL patients aged 47–79 years (20 men and 10 women). All patients underwent a General clinical blood test (SysmexXE 2100, Japan), morphological examination of the bone marrow (BioVision; Micros, Austria), immunophenotyping of bone marrow and peripheral blood by flow cytofluorometry (Navios10/3, Beckman Coulter, USA). B-cell clonality established by detection of restriction of light chains of surface immunoglobulins kappa or lambda. Morphological analysis of lymphocytes that differ in the expression of light chains of surface immunoglobulins: kappa (k) — group I (22 people — 73,3%), lambda (λ) — group II (8 people — 26,7%).Results. Determination of cell types by values of direct (FSC) and lateral (SSC) light scattering during immunophenotyping of peripheral blood and bone marrow samples showed that in patients of group I (CD19k+/CD5+/CD23+) on the light scattering diagram, the lymphoid population had low parameters: on the FSC scale — from 200 to 400, on the SSC — from 10 to 160 units, which indicates morphological uniformity of cells. In group II (CD19λ+/CD5+/CD23+), on the contrary, on the light scattering sketogram, the lymphoid zone was heterogeneous and stretched: on the FSC scale — from 200 to 1000, on the SSC — from 10 to 400 units, which indicates morphological polymorphism of cells. There were also differences in the expression of the common leukocyte antigen CD45. In group I, the expression is higher: the population of B-lymphocytes in terms of fluorescence intensity is on the dot graph on the CD45 scale in the second half of the third decade and in the fourth decade — to the right, than in group II, in which B-lymphocytes lie in the third decade. The data indicate that the CD19k+/CD5+/CD23+ population is represented by Mature cells, while the Cd19k+/CD5+/CD23+ population is represented by less Mature and / or intermediate forms. Significant morphological differences in lymphocyte populations were also observed in microscopic studies of blood and bone marrow preparations.Conclusion. The established immunophenotypic and morphological differences in lymphoid populations expressing either kappa — or lambda-light chains of immunoglobulins may be important for identifying risk groups among patients with biologically heterogeneous variants of chronic lymphocytic leukemia.