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Immunophenotypic analysis of Waldenstrom's macroglobulinemia.
Semin Oncol. 2003 Apr; 30(2):187-95.SO

Abstract

Immunophenotyping has become an essential tool for diagnosis of hematological malignancies. By contrast, for diagnosis of Waldenstrom's macroglobulinemia (WM) immunophenotyping is used only occasionally. From 150 patients with a IgM monoclonal gammopathy we have selected 60 cases with (1) morphological lymphoplasmocytoid bone marrow (BM) infiltration (>20%); (2) IgM paraprotein (>10g/L); and (3) absence of features of other lymphoma types. Immunophenotypic analysis was based on the use of the triple or quadruple monoclonal antibody (MoAb) combinations. To increase the sensitivity of the analysis of antigen expression, selected CD19(+)CD20(+) B cells were targeted. We have also explored the antigenic characteristics of both the plasma cell (PC) and mast cell (MC) compartments present in the BM from 15 WM patients. Clonal WM lymphocytes were characterized by the constant expression of pan-B markers (CD19, CD20, CD22, CD24) together with sIg, predominantly kappa (5:1, kappa:lambda ratio). A high proportion of cases (75%) were positive for FMC7 and CD25, but in contrast to hairy cell leukemia (HCL), these lymphocytes were always negative for CD103 and CD11c. CD10 antigen was also absent in all WM patients and less than one fifth of patients were positive for CD5 and CD23, while CD27, CD45RA, and BCL-2 were present in most malignant cells. In two cases, the coexistence of two different clones of B lymphocytes was identified, and in eight additional cases, intraclonal phenotypic heterogeneity was observed. As far as PCs are concerned, in most patients (85%) the number of PCs was within the normal range (median, 0.36%). The antigenic profile of these PCs differed from that observed in normal and myelomatous PC (CD38(++)CD19(++/-)CD56(-)CD45(++)CD20(+)). In three cases, PCs showed aberrant expression for CD5, CD22, or FMC7. Finally, the number of mast cells was significantly higher (0.058 +/- 0.13) as compared to normal BM (0.019 +/- 0.02) (P <.01), although they were immunophenotypically normal (CD117(+)CD2(-)CD25(-)).

Authors+Show Affiliations

Servicio de Hematología, Hospital Universitario de Salamanca, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12720134

Citation

San Miguel, J F., et al. "Immunophenotypic Analysis of Waldenstrom's Macroglobulinemia." Seminars in Oncology, vol. 30, no. 2, 2003, pp. 187-95.
San Miguel JF, Vidriales MB, Ocio E, et al. Immunophenotypic analysis of Waldenstrom's macroglobulinemia. Semin Oncol. 2003;30(2):187-95.
San Miguel, J. F., Vidriales, M. B., Ocio, E., Mateo, G., Sánchez-Guijo, F., Sánchez, M. L., Escribano, L., Bárez, A., Moro, M. J., Hernández, J., Aguilera, C., Cuello, R., García-Frade, J., López, R., Portero, J., & Orfao, A. (2003). Immunophenotypic analysis of Waldenstrom's macroglobulinemia. Seminars in Oncology, 30(2), 187-95.
San Miguel JF, et al. Immunophenotypic Analysis of Waldenstrom's Macroglobulinemia. Semin Oncol. 2003;30(2):187-95. PubMed PMID: 12720134.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Immunophenotypic analysis of Waldenstrom's macroglobulinemia. AU - San Miguel,J F, AU - Vidriales,M B, AU - Ocio,E, AU - Mateo,G, AU - Sánchez-Guijo,F, AU - Sánchez,M L, AU - Escribano,L, AU - Bárez,A, AU - Moro,M J, AU - Hernández,J, AU - Aguilera,C, AU - Cuello,R, AU - García-Frade,J, AU - López,R, AU - Portero,J, AU - Orfao,A, PY - 2003/4/30/pubmed PY - 2003/6/5/medline PY - 2003/4/30/entrez SP - 187 EP - 95 JF - Seminars in oncology JO - Semin. Oncol. VL - 30 IS - 2 N2 - Immunophenotyping has become an essential tool for diagnosis of hematological malignancies. By contrast, for diagnosis of Waldenstrom's macroglobulinemia (WM) immunophenotyping is used only occasionally. From 150 patients with a IgM monoclonal gammopathy we have selected 60 cases with (1) morphological lymphoplasmocytoid bone marrow (BM) infiltration (>20%); (2) IgM paraprotein (>10g/L); and (3) absence of features of other lymphoma types. Immunophenotypic analysis was based on the use of the triple or quadruple monoclonal antibody (MoAb) combinations. To increase the sensitivity of the analysis of antigen expression, selected CD19(+)CD20(+) B cells were targeted. We have also explored the antigenic characteristics of both the plasma cell (PC) and mast cell (MC) compartments present in the BM from 15 WM patients. Clonal WM lymphocytes were characterized by the constant expression of pan-B markers (CD19, CD20, CD22, CD24) together with sIg, predominantly kappa (5:1, kappa:lambda ratio). A high proportion of cases (75%) were positive for FMC7 and CD25, but in contrast to hairy cell leukemia (HCL), these lymphocytes were always negative for CD103 and CD11c. CD10 antigen was also absent in all WM patients and less than one fifth of patients were positive for CD5 and CD23, while CD27, CD45RA, and BCL-2 were present in most malignant cells. In two cases, the coexistence of two different clones of B lymphocytes was identified, and in eight additional cases, intraclonal phenotypic heterogeneity was observed. As far as PCs are concerned, in most patients (85%) the number of PCs was within the normal range (median, 0.36%). The antigenic profile of these PCs differed from that observed in normal and myelomatous PC (CD38(++)CD19(++/-)CD56(-)CD45(++)CD20(+)). In three cases, PCs showed aberrant expression for CD5, CD22, or FMC7. Finally, the number of mast cells was significantly higher (0.058 +/- 0.13) as compared to normal BM (0.019 +/- 0.02) (P <.01), although they were immunophenotypically normal (CD117(+)CD2(-)CD25(-)). SN - 0093-7754 UR - https://www.unboundmedicine.com/medline/citation/12720134/Immunophenotypic_analysis_of_Waldenstrom's_macroglobulinemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0093775403000411 DB - PRIME DP - Unbound Medicine ER -