Immunophenotypic subclassification of chronic lymphocytic leukaemia (CLL)

Abstract

To determine the significance of the immunophenotypic heterogeneity of B-cell chronic lymphocytic leukaemia (CLL), surface immunoglobulins (SIgs), mouse rosette assays (MR), and a panel of monoclonal antibodies for B cells, T cells and myeloid cells were performed on peripheral blood samples from 61 newly diagnosed cases. Four groups were observed: group I (SIg+, MR+, CD19/20+, CD5+, T antigen (Ag)-; 27 cases); group II (SIg+, MR+, CD19/20+, CD5+, T Ag+; 17 cases); group III (SIg+, MR+ CD19/20+, CD5-, T AG-; 12 cases); and group IV (SIg-, MR+, CD19/20+, Cd5+, T Ag-; 5 cases). Groups were compared according to French-American-British Cooperative Group subtypes, clinical and laboratory features, Rai staging, and survival. Typical CLL morphology (greater than 90% small lymphocytes) was present in 20/20 (100%) of group I cases and 23/27 (85%) group II, III and IV cases (P = 0.09). Expression of a myeloid antigen was seen in 5/27 group I cases (18%) and 1/16 group II cases (6%), but was not predictive of survival (P = 0.36). The CD5- group III had a lower haemoglobin level (P less than 0.0001), higher Rai stage (P less than 0.002), and poorer survival at 5 years (P less than 0.02) than the other groups. We conclude that at least four distinct immunophenotypic subgroups of B-cell CLL can be determined. Expression of myeloid or T-cell antigens does not appear to predict for patient survival; however, lack of CD5 antigen may be associated with more advanced stage of disease and poor patient survival.

Chronic Lymphocytic Leukemia with Aberrant CD8 Expression and Atypical Morphology: A Case Report and Review

“…Some reports suggested that CD8 expression was associated with a favorable prognosis either in terms of lack of progression or good response to treatment [4][5][6][7][8][9][10][11][12]; however, other reports suggested CD8 as a marker of aggressive disease [13,14]. Our patient showed an indolent clinical course.…”

“…Most are reports of single cases or small case series. It is not clear whether CD8 expression is associated with disease progression [4][5][6][7][8][9][10][11][12].…”

Four aged siblings with B cell chronic lymphocytic leukemia

“…This immunophenotype is fully compatible with B-CLL (Table 1). [4][5][6][7][8] In patients MZ and JZ, the vast majority of CD19 + B lymphocytes were monoclonal, because they expressed SmIg / and SmIg /␦/ , respectively. However in patient LZ approximately 20% of B lymphocytes expressed SmIg and approximately 80% expressed SmIg in addition to Ig /␦, suggesting the presence of two B-CLL clones.…”

“…A part of the B-CLL express the CD21 antigen or the IL-2 receptor ␣ chain (CD25 antigen). [4][5][6][7][8] The etiology of B-CLL is still unclear. An increased risk of CLL has been reported among farmers working in soybean production, in cattle raising, in dairy production and with herbicides, 9,10 as well as among asbestos workers 11,12 and among workers in rubber manufacturing.…”

Autoimmune haemolytic anaemia emerging during Campath treatment in a patient with CD5 negative chronic lymphocytic leukaemia

“…Its usefulness extends to autoimmune cytopenias [3], at times developing in the course of CLL [4,5]. The CD5 negative variant of B CLL ranges in frequency between 7 % and 20 % according to series [6,7], is associated with Binet stage A and splenomegaly at diagnosis [8] and runs an aggressive clinical course [9]. Herein we describe a case of progressive CD5 negative B CLL complicated by autoimmune haemolytic anaemia (AIHA) at the 8th week of Campath treatment.…”