The Value Of A Small Panel Of Monoclonal Antibodies For The Differential Diagnosis Of Lymphoproliferative Syndromes [o Uso De Um Pain El Restrito De Anticorpos Monoclonais No Diagnóstico Diferencial Das Síndromes Linfoproliferativas]

The immunological profile and the morphology of lymphoid cells are the main diagnostic clues for a correct differential diagnosis of chronic lymphoproliferative disorders. In the present study, we used a small panel of monoclonal antibodies for this purpose: CD19/CD10, CD20/CD5, CD23, CD3/CD4, CD3/CD8, kappa chain/lambda chain (for the detection of surface immunoglobulin). This panel was applied in 44 patients seen at our Service, using peripheral blood or lymph node morphology as a confirmatory element. Among them 29 had a typical immunologic profile of B-CLL (16 with kappa light chain and 13 with lamba chain restriction) and 2 were T-CLL. In 8 cases, immunologic study needed peripheral blood morphology for diagnostic confirmation: 6 cases of immunocytoma and 2 prolymphocytic leukemias. The 5 patients with mantle cell lymphoma were diagnosed based on the immunologic profile of peripheral blood or lymph node aspirates. The present observation underlines the importance of the immunophenotype in the correct diagnosis of the chronic lymphoproliferative syndromes. The small panel used was sufficient, when morphological examination of peripheral blood or lymph node was used for diagnostic confirmation if necessary.2214145Dighiero, G., Binet, J.L., Chronic Iymphocytic leukemia (1996) Hematol Cell Ther, 38, pp. S41-S61Garand, R., Robillard, N., Immunophenotypic characterization of acute leukemias and chronic lymphoproliferative disorders (1996) Hematol Cell Ther, 38, pp. 471-486Matutes, E., Owusu-Ankomah, K., Morilla, R., The immunological profile of B-cell disorders and proposal of a scoring system for the diagnosis of CLL (1994) Leukemia, 8, pp. 1640-1645General Haematology Task Force of BCSH Immunophenotyping in the diagnosis of chronic lymphoproliferative disorders (1994) J Clin Pathol, 47, pp. 871-875DiGiuseppe, J.A., Borowitz, M.J., Clinical utility of flow cytometry in the chronic lymphoid leukemias (1998) Semin Oncol, 25, pp. 6-10Oliveira, M.S.P., Loureiro, P., Bittencourt, A., Geographic diversity of adult T-cell leukemia/lymphoma in Brazil (1999) Int J Cancer, 83, pp. 291-298Huang, J.C., Finn, W.G., Goolsby, C.L., Variakojis, D., Peterson, L.A.C., CD5- Small B-cell leukemias are rarely classifiable as chronic lymphocytic leukemia (1999) Am J Clin Pathol, 111, pp. 123-130Lydard, P.M., Jewell, A.P., Jamin, C., Youinou, P.Y., CD5 B cells and B-cell malignancies (1999) Curr Opin Hematol, 6, pp. 30-36Pangalis, G.A., Angelopoulou, M.K., Vassilakopoulos, T.P., Slakantaris, M.P., Kittas, C., B-chronic lymphocytic leukemia, small lymphocytic lymphoma, and lymphoplaspacytic lymphoma, including Waldenström's macroglobulinemia (1999) Semin Hematol, 36, pp. 104-114Damle, R.N., Wasil, T., Fais, F., Ig v gene mutation status and CD38 expression as novel prognostic indicators in chronic lymphocytic leukemia (1999) Blood, 94, pp. 1840-1847Lorand, I., Souza, C.A., Kneubil, D.B., Leucemia prolinfocítica: Respuesta favorable a radioterapia esplénica (1981) Sangre, 26, p. 262Lorand-Metze, I., Oliveira, G.B., Aranha, F.J., Treatment of prolymphocytic leukemia with cladribine (1998) Ann Hematol, 76, pp. 85-8