Hematopathology Department, ACTREC, Tata Memorial Center, Homi Bhabha National Institute (HBNI) University, Navi Mumbai, Maharashtra, India.
Department of Pathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India.
Cytometry B Clin Cytom. 2024 Sep;106(5):359-369. doi: 10.1002/cyto.b.22193. Epub 2024 Jun 21.
Multicolor flow cytometry (MFC) is crucial in detecting occult or minimal bone marrow (BM) involvement by non-Hodgkin lymphomas (NHL), which may not be detected using trephine biopsy or imaging studies. Detection of low-level BM involvement can be challenging without definite immunophenotypic aberrancies. We studied the utility of CD305 in MFC detection of minimal BM involvement by B-NHL, especially in the absence of aberrancies by commonly used markers. The study included 1084 consecutive BM samples submitted for the staging of B-NHLs (excluding CLL) over two years. Samples were studied for morphological, immunophenotypic, and histopathological assessment. MFC studies were performed using 10-13 color MFC, including CD305-antibody (clone, DX26). Minimal BM involvement was defined with a cutoff of ≤10% lymphoma cells in viable cells on MFC assessment. Of 1084, 148 samples revealed overt morphological involvement by B-NHL and were excluded from analysis. BM samples of 172/936 patients were morphologically negative but revealed involvement using MFC independently. Corresponding trephine biopsy involvement was detected in only 79/172 (45.9%) patients. On MFC, 23/172 samples showed BM involvement with >10% lymphoma cells, and 149/172 (86.6%) samples revealed minimal involvement. In 54/149 (36.24%) samples, lymphoma cells were detected only with aberrant loss of CD305 expression. In 78 of the remaining 95 samples (82.1%), it provided an immunophenotypic aberrancy addition to other markers and supported the results. CD305 is a highly useful marker in the flow cytometric assessment of minimal BM involvement by B-NHL. MFC is a superior modality to trephine biopsy in detecting low-level BM involvement.
多色流式细胞术（MFC）在检测非霍奇金淋巴瘤（NHL）隐匿性或微小骨髓（BM）浸润中至关重要，而骨髓穿刺活检或影像学研究可能无法检测到这些浸润。在没有明确免疫表型异常的情况下，检测低水平的 BM 浸润可能具有挑战性。我们研究了 CD305 在 MFC 检测 B-NHL 微小 BM 浸润中的应用价值，特别是在缺乏常用标志物异常的情况下。该研究纳入了两年间为分期诊断 B-NHL（不包括 CLL）而送检的 1084 例连续 BM 样本。对这些样本进行了形态学、免疫表型和组织病理学评估。使用包括 CD305 抗体（克隆，DX26）的 10-13 色 MFC 进行 MFC 研究。在 MFC 评估中，将活细胞中淋巴瘤细胞≤10%定义为微小 BM 浸润。在 1084 例样本中，有 148 例显示明显的 B-NHL 形态学受累，因此被排除在分析之外。172/936 例患者的 BM 样本形态学为阴性，但通过 MFC 独立显示受累。仅有 79/172（45.9%）例患者的相应骨髓穿刺活检显示受累。在 MFC 上，有 23/172 例样本显示 BM 浸润的淋巴瘤细胞＞10%，149/172（86.6%）例样本显示微小浸润。在 54/149（36.24%）例样本中，仅通过异常丧失 CD305 表达检测到淋巴瘤细胞。在其余 95 例（82.1%）样本中，它除了其他标志物外还提供了免疫表型异常，并支持了检测结果。CD305 是 B-NHL 微小 BM 浸润的流式细胞术评估中非常有用的标志物。与骨髓穿刺活检相比，MFC 是检测低水平 BM 浸润的更优越的方法。
