Reagents of clinical utility in the evaluation of mature B-cell lymphoid neoplasms
| Reagent . | Normal distribution of staining . | Clinical utility in mature B-cell lymphoid malignancy . | Comments . |
|---|---|---|---|
| CD5 | T cells and minor B-cell subset. | Expression on B cells: CLL, MCL. | — |
| CD10 | Immature T cells and B cells, subset of mature T cells and B cells, and neutrophils. | Germinal center–like phenotype: FL, DLBCL, BL. Frequently present in ALL. | |
| CD19 | All B cells, including lymphoblasts, mature B-lymphoid cells, and most plasma cells. | Indicates B-cell lineage. May demonstrate abnormal intensity in B-cell neoplasms. Usually absent in plasma cell neoplasms. | Aberrant expression on myeloid cells in AML or MDS. |
| CD20 | Acquired during maturation of precursor B cells (hematogones). Mature B-lymphoid cells positive. Absent on most BM plasma cells. Minor T-cell subset. | Supports B-cell lineage. Intensity often differs between subtypes: CLL/SLL dim, FL brighter. Aberrant expression on ALL or PCN. | Present on T-cell lymphoid neoplasms. |
| CD45 | All B cells (weaker intensity on precursors and plasma cells), all T cells (weaker intensity on precursors). | Useful in distinguishing mature lymphoid neoplasms (bright intensity) from ALL and PCN (weak intensity to negative). | — |
| Kappa and lambda, surface | Mature B cells. | Immunoglobulin light chain restriction. | — |
| CD9* | Precursor B cells, activated T cells, platelets. | Precursor B-cell ALL. | — |
| CD11c* | Some B cells, some T cells. | Hairy cell leukemia CD11c (+ br.). | Frequent weaker expression on CLL, MCL and others. |
| CD15* | Myeloid and monocytic cells. | May be aberrantly expressed in B-cell neoplasia. | More frequently seen in ALL than in mature neoplasm. |
| CD22* | Cytoplasmic expression in early B cells. Surface expression acquired during maturation of precursor B cells. | Indicates B-cell lineage in ALL and mature lymphoid neoplasms. Intensity often differs between subtypes of mature B-cell neoplasm: CLL/SLL dim. | Cross reactivity of some clones with monocytes and basophils. |
| CD23* | Weak intensity expression on resting B cells and increased with activation. | Distinguish CD5+B-cell lymphoid neoplasms: CLL/SLL (+ br). | — |
| CD25* | Activated B cells and T cells. | Hairy cell leukemia in combination with CD11c and CD103. | — |
| CD13* | Myeloid and monocytic cells. | May be aberrantly expressed in B-cell neoplasia. | More frequently seen in ALL than in mature neoplasm. |
| CD33* | Myeloid and monocytic cells. | May be aberrantly expressed in B-cell neoplasia. | More frequently seen in ALL than in mature neoplasm. |
| CD34* | B-cell and T-cell precursors and myeloblasts. | ALL. | Also AML. |
| CD38* | Precursor B cells (hematogones), normal follicle center B cells, immature and activated T cells, plasma cells (bright intensity), myeloid and monocytic cells, and erythroid precursors. | Bright intensity staining may indicate plasmacytic differentiation. Prognostic marker in CLL/SLL. | — |
| CD43* | T cells, myeloid, monocytes, small B-cell subset. | Aberrant expression in CLL, MCL, some MZL. | — |
| CD58* | Leukocytes including bright intensity staining of precursors and decreased intensity with maturation. | Distinction of ALL from normal precursor B-cell (hematogones) including detection of MRD. | — |
| CD79a and b* | Cytoplasmic staining in precursor B cells, plasma cells positive, variable expression mature B cells. | Indicates B-cell lineage in ALL and mature lymphoid neoplasms. Intensity often differs between subtypes of mature B-cell neoplasm: CLL/SLL dim CD79b. | CD79a staining has been reported in some T-ALL and rare mature T-cell lymphoid neoplasms. |
| CD103* | B-cell subset, intramucosal T cells. | Hairy cell leukemia and some MZL. | Also EATCL. |
| FMC-7* | B cells. | Distinguish CD5+ lymphoid neoplasm: CLL−, MCL often positive. Also HCL+. | |
| bcl-2* | T cells, some B cells; negative normal germinal center cells. | Distinguish CD10+ lymphoid neoplasms: FL+, BL−. | Variable staining in DLBCL. |
| Kappa and lambda, cytoplasmic* | Plasma cells. | Light chain restriction in cells with plasmacytic differentiation. | Most flow cytometric assays detect surface and cytoplasmic Ig. |
| Zap-70* | T cells, NK cells, precursor B cells. | Prognostic marker in CLL/SLL. | — |
| TdT* | B-cell and T-cell precursors. | ALL. | Also some AML. |
| cIgM* | First Ig component in precursor B cells. Expressed by subset of plasma cells and mature B cells. | IgM producing neoplasms that might be associated with Waldenstrom macroglobulinemia | — |
| Reagent . | Normal distribution of staining . | Clinical utility in mature B-cell lymphoid malignancy . | Comments . |
|---|---|---|---|
| CD5 | T cells and minor B-cell subset. | Expression on B cells: CLL, MCL. | — |
| CD10 | Immature T cells and B cells, subset of mature T cells and B cells, and neutrophils. | Germinal center–like phenotype: FL, DLBCL, BL. Frequently present in ALL. | |
| CD19 | All B cells, including lymphoblasts, mature B-lymphoid cells, and most plasma cells. | Indicates B-cell lineage. May demonstrate abnormal intensity in B-cell neoplasms. Usually absent in plasma cell neoplasms. | Aberrant expression on myeloid cells in AML or MDS. |
| CD20 | Acquired during maturation of precursor B cells (hematogones). Mature B-lymphoid cells positive. Absent on most BM plasma cells. Minor T-cell subset. | Supports B-cell lineage. Intensity often differs between subtypes: CLL/SLL dim, FL brighter. Aberrant expression on ALL or PCN. | Present on T-cell lymphoid neoplasms. |
| CD45 | All B cells (weaker intensity on precursors and plasma cells), all T cells (weaker intensity on precursors). | Useful in distinguishing mature lymphoid neoplasms (bright intensity) from ALL and PCN (weak intensity to negative). | — |
| Kappa and lambda, surface | Mature B cells. | Immunoglobulin light chain restriction. | — |
| CD9* | Precursor B cells, activated T cells, platelets. | Precursor B-cell ALL. | — |
| CD11c* | Some B cells, some T cells. | Hairy cell leukemia CD11c (+ br.). | Frequent weaker expression on CLL, MCL and others. |
| CD15* | Myeloid and monocytic cells. | May be aberrantly expressed in B-cell neoplasia. | More frequently seen in ALL than in mature neoplasm. |
| CD22* | Cytoplasmic expression in early B cells. Surface expression acquired during maturation of precursor B cells. | Indicates B-cell lineage in ALL and mature lymphoid neoplasms. Intensity often differs between subtypes of mature B-cell neoplasm: CLL/SLL dim. | Cross reactivity of some clones with monocytes and basophils. |
| CD23* | Weak intensity expression on resting B cells and increased with activation. | Distinguish CD5+B-cell lymphoid neoplasms: CLL/SLL (+ br). | — |
| CD25* | Activated B cells and T cells. | Hairy cell leukemia in combination with CD11c and CD103. | — |
| CD13* | Myeloid and monocytic cells. | May be aberrantly expressed in B-cell neoplasia. | More frequently seen in ALL than in mature neoplasm. |
| CD33* | Myeloid and monocytic cells. | May be aberrantly expressed in B-cell neoplasia. | More frequently seen in ALL than in mature neoplasm. |
| CD34* | B-cell and T-cell precursors and myeloblasts. | ALL. | Also AML. |
| CD38* | Precursor B cells (hematogones), normal follicle center B cells, immature and activated T cells, plasma cells (bright intensity), myeloid and monocytic cells, and erythroid precursors. | Bright intensity staining may indicate plasmacytic differentiation. Prognostic marker in CLL/SLL. | — |
| CD43* | T cells, myeloid, monocytes, small B-cell subset. | Aberrant expression in CLL, MCL, some MZL. | — |
| CD58* | Leukocytes including bright intensity staining of precursors and decreased intensity with maturation. | Distinction of ALL from normal precursor B-cell (hematogones) including detection of MRD. | — |
| CD79a and b* | Cytoplasmic staining in precursor B cells, plasma cells positive, variable expression mature B cells. | Indicates B-cell lineage in ALL and mature lymphoid neoplasms. Intensity often differs between subtypes of mature B-cell neoplasm: CLL/SLL dim CD79b. | CD79a staining has been reported in some T-ALL and rare mature T-cell lymphoid neoplasms. |
| CD103* | B-cell subset, intramucosal T cells. | Hairy cell leukemia and some MZL. | Also EATCL. |
| FMC-7* | B cells. | Distinguish CD5+ lymphoid neoplasm: CLL−, MCL often positive. Also HCL+. | |
| bcl-2* | T cells, some B cells; negative normal germinal center cells. | Distinguish CD10+ lymphoid neoplasms: FL+, BL−. | Variable staining in DLBCL. |
| Kappa and lambda, cytoplasmic* | Plasma cells. | Light chain restriction in cells with plasmacytic differentiation. | Most flow cytometric assays detect surface and cytoplasmic Ig. |
| Zap-70* | T cells, NK cells, precursor B cells. | Prognostic marker in CLL/SLL. | — |
| TdT* | B-cell and T-cell precursors. | ALL. | Also some AML. |
| cIgM* | First Ig component in precursor B cells. Expressed by subset of plasma cells and mature B cells. | IgM producing neoplasms that might be associated with Waldenstrom macroglobulinemia | — |
Reagents included in this table were recommended in the consensus guidelines.
+ indicates usually positive; −, usually negative; b, bright or strong intensity; Ig, immunoglobulin; TdT, terminal deoxynucleotidyl transferase; clg, cytoplastic immunoglobulin; and —, not applicable.
These reagents may be considered for secondary evaluation, after other reagents listed have been used in the initial evaluation.