Immunophenotypic features of bone marrow tumor cell in Burkitt lymphoma/leukemia: B-lineage acute lymphoblastic leukemia diagnostics opportunities

Bone marrow tumor blasts immunophenotyping is an essential part of Burkitt lymphoma/leukemia (BL) and B-cell precursor acute lymphoblastic leukemia (BCP-ALL) differential diagnostics. Nevertheless immunoglobulin heavy and light chains detection on the cell surface could meet several biological and methodological pitfals. Thus the aim of the present study was development of additional BL immunophenotypic criteria. Leukemic blasts antigen profile in 21 BL cases and 84 children with BCP-ALL was compared in a retrospective way. Antigen expression patterns in BL and BCP-ALL were significantly different. It was shown that even in cases with weak immunoglobulin M expression these two tumor types could be distinguished well by complex immunophenotype analysis. In present study all cases of CD34-negative B-lineage ALL without myeloid coexpression and with high CD20-positive cells proportion belonged to BL.

Burkitt lymphoma/leukemia, acute lymphoblastic leukemia, flow cytometry

1. Kelemen K., Braziel R.M., Gatter K. et al. Immunophenotypic variations of Burkitt lymphoma. Am J Clin Pathol 2010; 134:127–38. DOI: 10.1309/AJCP93LJPTRQPDKR.

2. Клинические рекомендации по диагностике и лечению лимфомы Беркитта. II Конгресс гематологов России, 2014. [Clinical recommendations for the diagnosis and treatment of Burkitt’s lymphoma. II Hematology Congress in Russia, 2014. (In Russ.)].

3. Martinez A., Ponzoni M., Agostinelli C. et al. International Extranodal Lymphoma Study Group. Primary bone marrow lymphoma: an uncommon extranodal presentation of aggressive non-Hodgkin lymphomas. Am J Surg Pathol 2012;36(2):296–304. DOI: 10.1097/PAS.0b013e31823ea106.

4. Dalla-Favera R., Bregni M., Erikson J. et al. Human c-myc onc gene is located on the region of chromosome 8 that is translocated in Burkitt lymphoma cells. Proc Natl Acad Sci USA 1982; 79(24):7824–7. PMID: 6961453.

5. Schmitz R., Young R.M., Ceribelli M. et al. Burkitt lymphoma pathogenesis and therapeutic targets from structural and functional genomics. Nature 2012;490(7418):116–20. DOI: 10.1038/nature11378.

6. Love C., Sun Z., Jima D. et al. The genetic landscape of mutations in Burkitt lymphoma. Nat Genet 2012;44(12):1321–5. DOI: 10.1038/ng.2468.

7. Richter J., Schlesner M., Hoffmann S. et al. Recurrent mutation of the ID3 gene in Burkitt lymphoma identified by integrated genome, exome and transcriptome sequencing. Nat Genet 2012;44(12):1316–20. DOI: 10.1038/ng.2469.

8. McGowan P., Nelles N., Wimmer J. et al. Chang Differentiating between Burkitt lymphoma and CD10+ diffuse large B-cell lymphoma: the role of commonly used flow cytometry cell markers and the application of a multiparameter scoring system. Am J Clin Pathol 2012;137(4):665–70. DOI: 10.1309/AJCP3FEPX5BEEKGX.

9. Coche D., Bergues B., Harrivel V., Guillaume N. Biphenotypic acute leukaemia with Burkitt-like cytology. Ann Biol Clin (Paris) 2009;67:437–40. DOI: 10.1684/abc.2009.0337.

10. Bene M., Castoldi G., Knapp W. et al. Proposals for the immunological classification of acute leukemias. European Group for the Immunological Characterization of Leukemias (EGIL). Leukemia 1995;9(10):1783–6. PMID: 7564526.

11. Kelemen K., Braziel R.M., Gatter K. et al. Immunophenotypic Variations of Burkitt Lymphoma. Am J Clin Pathol 2010;134:127–38. DOI: 10.1309/AJCP93LJPTRQPDKR.

12. Zweig M.H., Campbell G. Receiveroperating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem 1993;31:561–77. PMID: 8472349.

13. Obuchowski N.A. ROC analysis. Am J Roentgenol 2005;184:364–72. DOI: 10.2214/ajr.184.2.01840364.

14. Weinstein S., Obuchowski N.A., Lieber M.L. Clinical evaluation of diagnostic tests. Am J Roentgenol 2005;184:14–9. DOI: 10.2214/ajr.184.1.01840014.

15. Veltroni M., De Zen L., Sanzari M.C. et al. Expression of CD58 in normal, regenerating and leukemic bone marrow B cells: implications for the detection of minimal residual disease in acute lymphocytic leukemia. Haematologica 2003;88(11):1245–52. PMID: 14607753.

16. Lee R.V., Braylan R.C., Rimsza L.M. A CD58 expression decrease as nonmalignant B cells mature in bone marrow and is frequently overexpressed in adult and pediatric precursor B-cell acute lymphoblastic leukemia. Am J Clin Pathol 2005;123(1):119–24. PMID: 15762287.

17. Попов А.М., Вержбицкая Т.Ю., Цаур Г.А. и др. Аберрации иммунофенотипа, применимые для мониторинга минимальной остаточной болезни методом проточной цитометрии при CD10-позитивном остром лимфобластном лейкозе из В-линейных предшественников. Иммунология 2010;6:299–304. [Popov A.M., Verzhbitskaya T.Yu., Tsaur G.A. et al. Immunophenotype aberrations useful for minimal residual disease monitoring by flow cytometry in CD10-positive B-precursor acute lymphoblastic leukemia. Immunologiya = Immunology 2010;6:299–304. (In Russ.)].