Chronic

Lymphoid Disorders:
Useful Informa8on
 Panels for B-cell Analysis

•  Panels with sequen8al analysis…

–  Gate tube: CD19, CD33, CD34, CD45 (screening)
–  Basic lymphoid panel:
•  For B cells: CD19, CD38, kappa, lambda
•  For T cells: CD3, CD4, CD5, CD8
–  Extended B-cell panel:
•  CD5, CD10, CD19, CD20, CD23, CD11c or CD200, kappa,
lambda
 Mature B-cell neoplasm classifica8on
Small / Medium mature B-lineage neoplasms

CD5+/CD10- CD5-/CD10+ CD5-/CD10-

CLL/SLL Follicular Marginal Zone
Mantle Cell Burkitt (med. size) Lymphoplasmacytic
Hairy Cell (med. Size)

CD23+/CD200+ CD23-/CD200-
CLL/SLL Mantle Cell
 T-cell lymphoma cases: Panel used
PerCP-
Screening PacB PacO FITC PE
Cy5.5
PECY7 APC APCH7

Lymphoid CD4 CD45 CD8 CD56 CD5 AnG- smCD3 CD38

Screening CD20 An8-sIgλ An8-sIgκ TCRγδ
Tube: LST CD19

PerCP APC
TCLPD PacB PacO FITC PE PECY7 APC AIM
Cy5.5 H7
tube

1 CD4 CD45 CD7 CD26 smCD3 CD2 CD28 CD8 IdenGficaGon Sézary Sy.

2 CD4 CD45 CD27 CCR7 smCD3 CD45RO CD45RA CD8 MaturaGon stage

3 CD4 CD45 CD5 CD25 smCD3 HLADR cyTCL1 CD8 T-PLL

4 CD4 CD45 CD57 CD30 smCD3 CD11c CD8 Cytotoxic phenotype & ALCL

5 CD4 CD45 cyPerf cyGrz smCD3 CD16 CD94 CD8 Cytotoxic phenotype & T-LGL

6 CD4 CD45 CD279 smCD3 CD8 AITL

T-PLL: T-cell prolymphocytic leukemia, ALCL: Anaplastic large cell lymphoma, T-LGL: T-cell large granular lymphocytic leukemia,
AITL: Angioimmunoblastic T-cell lymphoma
Cy: cytoplasmic, Perf: Perforin, Grz: Granzyme
 Cytotoxic T-cell differen8a8on

Effector (Peripheral) Memory

Central
AnGgen Naive Intermediate Late Effector
Memory Early
(TransiGonal) (EMRA)
CD45RA + - - -/+ + +
CD45RO - + + +/- - -
CCR7 + + - - - -
CD27 + + + +/- - -
CD28 + + + -/+ - -
Cytotoxic* - + + ++ +++ ++++
*Cytotoxic proteins: TIA-1, granzyme-B, perforin

Most also CD8+ and express NK-associated an8gens

 Flow cytometry for mature
T-/NK-cell neoplasms
•  CD4 nega8ve & CD8 posi8ve or nega8ve:
–  T-cell large granular lymphocyte leukemia (LGL)
–  Chronic lymphoprolifera8ve disorder (CLPD) NK-cells
–  Nasal NK / T-cell lymphoma, aggressive NK-cell leukemia
–  Enteropathy associated T-cell lymphoma (EATL)
–  Peripheral T-cell lymphoma (PTCL), NOS
•  CD4 posi8ve & CD8 nega8ve:
–  Sezary syndrome / cutaneous T-cell lymphoma (CTCL)
–  Adult T-cell leukemia / lymphoma (ATLL)
–  T-cell prolymphocy8c leukemia (PLL)
–  Angioimmunoblas8c T-cell lymphoma (AITL)
–  Anaplas8c large cell lymphoma (ALCL)
–  Peripheral T-cell lymphoma (PTCL), NOS
•  CD4 posi8ve & CD8 posi8ve:
•  T-cell prolymphocy8c leukemia (PLL)
 CD4 nega8ve & CD8 posi8ve or nega8ve

•  T-cell large granular lymphocyte leukemia (LGL):

•  sCD3+, CD56-/+, CD57+; usually decreased CD5 & CD7
•  Chronic lymphoprolifera8ve disorder (CLPD) NK-cells:
•  sCD3-, CD56+, CD57-
•  Nasal NK / T-cell lymphoma, aggressive NK-cell
leukemia:
•  sCD3-, CD5-, CD56++, CD57+; CD158a, b and e; cytotoxic;
EBV posi8ve
•  Enteropathy associated T-cell lymphoma (EATL):
•  Usually CD103+
•  Peripheral T-cell lymphoma (PTCL), NOS: varied
 CD4 posi8ve & CD8 nega8ve
•  Sezary syndrome / CTCL:
–  CD7-, CD25 variable, CD26-; central memory-like; leukemic and/
or characteris8c skin findings
•  Adult T-cell leukemia / lymphoma (ATLL):
–  CD7-, CD25++, HLA-DR+; FOXP3; T-reg-like; HTLV-1 associated
•  T-cell prolymphocy8c leukemia (PLL):
–  Reten8on CD7, CD5 and CD2; may lack CD45 or CD3; naïve or
central memory-like, TCL-1+; cytogene8cs
•  Angioimmunoblas8c T-cell lymphoma (AITL):
–  Follicular T-helper-like (CD10, CD279); maybe sCD3 nega8ve;
characteris8c morphology
•  Anaplas8c large cell lymphoma (ALCL):
–  Usually very large cells (maybe lost); maybe sCD3 nega8ve,
CD30+; ac8vated cytotoxic-like; Alk-1+; ALK gene
•  Peripheral T-cell lymphoma (PTCL), NOS: varied
 CD4 posi8ve & CD8 posi8ve

•  T-cell prolymphocy8c leukemia (PLL):

–  Reten8on CD7, CD5 and CD2; may lack CD45 or
CD3; naïve or central memory-like, TCL-1+;
cytogene8cs