Liu Y C, Cleveland R P, Madelaire C, Hines J D
Department of Pathology, MetroHealth Medical Center, Cleveland, OH 44109.
Arch Pathol Lab Med. 1995 Jan;119(1):53-8.
This study consisted of 10 cases of chronic B-cell lymphoproliferative disorders that had simultaneous specimens obtained from both bone marrow and peripheral sites for flow cytometric immunophenotyping. The immunophenotyping results of peripheral sites from all 10 cases showed a monoclonal B-cell proliferation expressing monoclonal surface immunoglobulin, CD19, CD20, HLA-DR, and CD5 (except 1 case). Eight (80%) of the 10 cases, however, demonstrated discordant immunophenotypes with myeloid-associated marker expression (CD13, CD11b, and/or CD15) found only in the bone marrow. Patients with CD13 or CD11b marker expression in the bone marrow followed an aggressive clinical course with advanced Rai's stage and a diffuse or mixed bone marrow infiltration pattern or disease transformation. These results indicate that discordant immunophenotypes of malignant cells from different body sites occur in chronic B-cell lymphoproliferative disorders and are not uncommon. Additionally; myeloid-associated markers, which some investigators have described as being associated with an unfavorable clinical course, may be expressed only in bone marrow specimens in these disorders. Thus, bone marrow specimens may be preferential in determining myeloid-associated marker expression in chronic B-cell lymphoproliferative disorders.
本研究包括10例慢性B细胞淋巴增殖性疾病患者，这些患者同时获取了骨髓和外周部位的标本用于流式细胞术免疫表型分析。所有10例患者外周部位的免疫表型分析结果显示，存在表达单克隆表面免疫球蛋白、CD19、CD20、HLA - DR和CD5的单克隆B细胞增殖（1例除外）。然而，10例患者中有8例（80%）表现出免疫表型不一致，髓系相关标志物表达（CD13、CD11b和/或CD15）仅在骨髓中发现。骨髓中表达CD13或CD11b标志物的患者临床病程进展迅速，Rai分期较高，骨髓呈弥漫性或混合性浸润模式或疾病转化。这些结果表明，慢性B细胞淋巴增殖性疾病中不同身体部位的恶性细胞存在免疫表型不一致的情况，且并不罕见。此外，一些研究者描述为与不良临床病程相关的髓系相关标志物，在这些疾病中可能仅在骨髓标本中表达。因此，在确定慢性B细胞淋巴增殖性疾病中髓系相关标志物表达时，骨髓标本可能更具优势。
