TY - JOUR
T1 - Hematogones with light chain restriction
T2 - A potential diagnostic pitfall when using flow cytometry analysis to assess bone marrow specimens
AU - El Hussein, Siba
AU - Wang, Wei
AU - Wang, Sa A.
AU - Fang, Hong
AU - Garces, Sofia
AU - Tashakori, Mehrnoosh
AU - Lyapichev, Kirill A.
AU - Qiu, Lianqun
AU - Wang, Xiaoqiong
AU - Loghavi, Sanam
AU - Medeiros, L. Jeffrey
AU - Challagundla, Pramoda
AU - Jorgensen, Jeffrey L.
N1 - Funding Information:
No Acknowledgements need to be made.
Publisher Copyright:
© 2021
PY - 2021/12
Y1 - 2021/12
N2 - Light-chain restricted hematogones (LCR HGs) detected by flow cytometry analysis can mimic bone marrow involvement by B-cell lymphoma. This phenomenon can present a diagnostic pitfall and negatively impact patient management, as misinterpretation may upgrade disease stage. In this study, we characterized the immunophenotype of LCR HGs with an aim to differentiate them from B-cell lymphoma. We analyzed 24 patients with LCR HGs, 12 (50 %) were kappa light chain restricted and 12 (50 %) were lambda light chain restricted. LCR HGs account for 51 % (range, 1.5%–99%) of B cells, and 0.5 % (range, 0.1%–3.7%) of total cells. In 15 patients in whom multiple specimens were analyzed, 10 (67 %) showed persistent LCR HGs in more than 1 specimen, and the duration of the light chain restriction ranged from 4 months to 2 years. Among 24 patients, 4 (16.6 %) cases were concurrently involved by B-cell lymphoma/myeloma in addition to LCR HGs. With the exception of light chain restriction, LCR HGs showed a similar immunophenotype as normal HGs and had a distinct location on the CD45/Side Scatter (SSC) plot. They were also consistently positive for CD10, CD19, CD38 (bright), CD43, and CD200. CD20 expression showed a spectrum from dim/negative to positive.
AB - Light-chain restricted hematogones (LCR HGs) detected by flow cytometry analysis can mimic bone marrow involvement by B-cell lymphoma. This phenomenon can present a diagnostic pitfall and negatively impact patient management, as misinterpretation may upgrade disease stage. In this study, we characterized the immunophenotype of LCR HGs with an aim to differentiate them from B-cell lymphoma. We analyzed 24 patients with LCR HGs, 12 (50 %) were kappa light chain restricted and 12 (50 %) were lambda light chain restricted. LCR HGs account for 51 % (range, 1.5%–99%) of B cells, and 0.5 % (range, 0.1%–3.7%) of total cells. In 15 patients in whom multiple specimens were analyzed, 10 (67 %) showed persistent LCR HGs in more than 1 specimen, and the duration of the light chain restriction ranged from 4 months to 2 years. Among 24 patients, 4 (16.6 %) cases were concurrently involved by B-cell lymphoma/myeloma in addition to LCR HGs. With the exception of light chain restriction, LCR HGs showed a similar immunophenotype as normal HGs and had a distinct location on the CD45/Side Scatter (SSC) plot. They were also consistently positive for CD10, CD19, CD38 (bright), CD43, and CD200. CD20 expression showed a spectrum from dim/negative to positive.
KW - Daratumumab
KW - Flow cytometry analysis
KW - Hematogones
KW - Light chain restricted hematogones
KW - Lymphoma
KW - Myeloma
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U2 - 10.1016/j.leukres.2021.106704
DO - 10.1016/j.leukres.2021.106704
M3 - Article
C2 - 34735934
AN - SCOPUS:85117915652
SN - 0145-2126
VL - 111
JO - Leukemia Research
JF - Leukemia Research
M1 - 106704
ER -