EVALUATION OF CELL SURFACE ANTIGEN EXPRESSIONS IN CASE OF CHRONIC LYMPHOCYTIC LEUKEMIA

Öz

OBJECTIVE: Immunophenotyping is critical for the diagnosis of B cell malignancy. In this study, we aimed to evaluate the cell surface antigen expression percentages and densities by flow cytometry method in patients diagnosed with Chronic Lymphocytic Leukemia (CLL) clinically and morphologically.
MATERIAL AND METHODS: Flow cytometry results of peripheral venous blood of 33 CLL patients (12 females / 21 males) were retrospectively analyzed. First, lymphocytes were marked on the CD45-Side Scatter chart and antibody expression percentages and densities in this population were determined.
RESULTS: It was observed that all patients had CD5, CD19, CD20, CD23, CD200 and CD43 antigen expressions as in the classical pattern. Unlike the classical pattern, the expression of FMC7, which is not expected is over 30% in eight patients. While 6 of the cases showed kappa monoclonality, 15 of them showed lambda monoclonality, it was seen that both light chain expressions were below 30% in 11 cases. ZAP 70 expression was found in three cases (16%, 23%, 42%). Looking at the average percentage of antigen expressions of all cases, it is seen that CD5, CD19, CD20, CD23, CD200 and CD43 are above 80%.
CONCLUSIONS: Surface antigen expressions recommended to be checked in the diagnosis of CLL may not follow the rules defined in each case. In these cases, there is a need to search for more specific additional cell markers to enter the diagnostic algorithm.

Anahtar Kelimeler

• Chronic lymphocytic Leukemia
• Flow cytometry
• Cell surface antigen

KRONİK LENFOSİTİK LÖSEMİ VAKALARINDA HÜCRE YÜZEY ANTİJEN EKSPRESYONLARININ DEĞERLENDİRİLMESİ

Öz

AMAÇ: İmmünofenotipleme, B hücre malignitesi teşhisi için kritik öneme sahiptir. Bu çalışmada klinik ve morfolojik olarak Kronik Lenfositik Lösemi (KLL) tanısı almış vakalarımızda akım sitometri yöntemi ile hücre yüzey antijen ekspresyon yüzdelerini ve yoğunluklarını değerlendirmeyi amaçladık.
GEREÇ VE YÖNTEM: 33 KLL hastasının (12 kadın / 21 erkek) periferik venöz kanına ait akım sitometri sonuçları geriye dönük incelenmiştir. İlk olarak CD45-Side Scatter grafiği üzerinde lenfositler işaretlendi ve bu popülasyondaki antikor ekspresyon yüzdeleri ve yoğunlukları belirlendi.
BULGULAR: Tüm hastalarda klasik paternde olduğu gibi CD5, CD19, CD20, CD23, CD200 ve CD43 antijen ekspresyonlarının mevcut olduğu görülmüştür. Klasik paternden farklı olarak ekspresyonu beklenmeyen FMC7’nin sekiz hastada ekspresyonu %30 un üzerindedir. Vakaların 6’sı kappa, 15’i lambda monoklonalitesi gösterirken 11 vakada da her iki hafif zincir ekspresyonunun %30’un altında olduğu görüldü. ZAP 70 ekspresyonu üç vakada (%16, %23, %42) rastlanmıştır. Tüm vakaların antijen ekspresyonlarının ortalama yüzdelerine bakıldığında CD5, CD19, Cd20, Cd23, CD200 ve CD43 ün %80’nin üzerinde olduğu görülmektedir.
SONUÇ: KLL tanısında bakılması önerilen yüzey antijen ekspresyonları her vakada tanımlanan kurallara uymayabilir. Bu vakalarda tanı algoritmasına girecek daha spesifik ek hücre markırlarının araştırılmasına ihtiyaç ortaya çıkmaktadır.

Anahtar Kelimeler

• Kronik lenfositik lösemi
• Akım sitometri
• Hücre yüzey antijeni

Kaynakça

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