Immunophenotypic analysis of erythroid dysplasia and its diagnostic application in myelodysplastic syndromes

Background/Aim: Abnormal immunophenotypes of haematopoietic cells in myelodysplastic syndromes (MDS) have been identified by flow cytometry (FCM) as a typical characteristic of myeloid dysplasia. Considering that most MDS patients show varying degrees of erythroid dysplasia, we analysed the immunophenotypic feature of erythroblasts to evaluate its diagnostic application in MDS. Methods: Erythroid antigens CD71 and CD105 expression were analysed using FCM. The development index (DI) acquired by log transformation of the CD71/CD105 expression ratio was used to denote the erythroid maturation and distinguish patients with non‐clonal cytopenias from low‐risk MDS. The diagnostic quality of DI in distinguishing MDS from non‐clonal cytopenia patients was evaluated using the receiver–operator characteristic (ROC) curve. Results: Under‐expression of CD71 and over‐expression of CD105 were detected in erythroblasts of MDS patients compared with non‐clonal cytopenias. The diagnostic test showed good diagnostic power that the area under the ROC curve was greater than 0.9. The diagnostic sensitivity and specificity were 75.6% and 92.3%, respectively, according to the DI threshold defined by the ROC curve in low‐risk MDS patients with normal karyotypes. Moreover, the DI showed a positive correlation with the haemoglobin level, and the MDS patients with lower DI usually showed frequent red cell transfusion. The patients with a lower DI generally had the HLA‐DR15 allele or marrow hypocellularity. Conclusion: Developmental defects and immune‐associated factors may contribute to the erythroid dysplasia. The DI derived from ratios of CD71 and CD105 expression is a useful marker to characterise dyserythropioiesis associated with MDS and can be helpful in distinguishing it from dyerythropoiesis associated with non‐clonal disorders.     

免疫表型结合间期原位杂交法检测多发性骨髓瘤细胞遗传学异常

本研究旨在建立骨髓涂片荧光免疫表型结合间期原位杂交技术（FICTION），为检测多发性骨髓瘤（MM）患者的分子细胞遗传学提供新方法。以骨髓涂片为载体，通过标记FITC的抗CD138抗体筛选浆细胞（PC），比较筛选的PC比例与形态学检测的PC比例之间的差异。同时采用8号染色体着丝粒探针行间期荧光原位杂交技术，检测PC的8号染色体异常情况。结果表明：骨髓涂片上荧光抗体筛选的PC比例与骨髓形态学检测的PC比例相比无统计学差异（P〉0．05），9例患者中4例（44％）有8号染色体异常，其中8号染色体单体（-8）3例（33％），8号染色体三倍体（＋8）1例（11％）。结论：骨髓涂片FICTION技术具有简便、特异、准确的特点，可用于MM分子遗传学异常的研究。     

流式细胞分析梅毒患者外周血T淋巴细胞的免疫表型

目的　研究人类对梅毒螺旋体的细胞免疫反应特征 ,分析进入血液后的梅毒螺旋体对机体外周血中各淋巴细胞亚群及自然杀伤细胞 (NK)的影响情况。方法　通过流式细胞仪 ,运用标有异硫氰酸荧光素 (FITC)或藻红素 (PE)的CD单抗 ,分析了 2 4例未经驱梅治疗过的早期梅毒患者 (含泛发型皮疹、掌跖型皮疹及无皮疹型各 8例 )外周血中各T淋巴细胞免疫表型的特点。结果　 2 4例梅毒患者的外周血中总T、TH、NK细胞及TH/Ts的比值均明显低于正常人对照组 (P <0 0 1) ,而Ts的比例则显著高于正常人对照组 (P <0 0 1) ;另外皮疹呈泛发型、掌跖型、无皮疹型三组患者在上述免疫表型的比例方面相互比较 ,无统计学差异 (P >0 0 5 )。结论　未经驱梅治疗过的早期梅毒患者存在着明显的细胞免疫抑制 ,其中皮疹呈泛发型、掌跖型、无皮疹型三者基本上反映了进入血液后的梅毒螺旋体在不同皮肤屏障功能下的表现形式 ,而与机体外周血中T淋巴细胞亚群的变化之间无明显的相关关系     

原发性皮肤CD30阳性大细胞淋巴瘤1例

报告1例原发性皮肤恶性淋巴瘤。患者，女，14岁，左侧面部进行性肿胀3年余。病理报告为原发性皮肤CD30阳性大细胞淋巴瘤（PCCD30^ -LCL)。免疫组化染色示瘤细胞CD30阳性、CD45RO、CD20阴性。采用COP方案及CHOP-R方案化疗各1次后，效果较好，后失访。     

急性淋巴细胞白血病免疫分型的特点及其临床意义(英文)

目的为了探讨急性淋巴细胞白血病(ALL)各亚型免疫分型的特点及其临床意义。方法采用 CD45/SSC 双参数散点图设门,应用三色流式细胞术,对81例 ALL 的初诊患者骨髓标本进行免疫分型,并对其中45例进行核型分析。结果 (1)B-ALL 中 CD19表达最常见(阳性率为100%),而 T-ALL 中 CD5和 CD7表达阳性率最高,均为90%;B-ALL 和 T-ALL 都存在抗原交叉表达的现象;两组患者的完全缓解率(CR 率)并无显著差异(P>0.05)。(2)伴髓系抗原表达的急性淋巴细胞白血病(My~+ ALL)比较常见,本组达到39.5%,常累及 B 淋巴系统(占 My~+ ALL 的84.4%);各髓系抗原中以 CD13表达阳性率最高;此类患者的 CR 率较高,儿童 CR 率为72.2%,成人为78.6%。(3)急性杂合性白血病(HAL)的发病率为19.8%,以髓系、B 系共同表达者居多;并且 CD34表达阳性率较高(81.3%),该类患者 CR 率较低(儿童和成人分别为50%和40%)。(4)CD34在 B-ALL,My~+ALL 和 HAL 中表达阳性率较高,而 T-ALL 中少见(P<0.025)。结论免疫分型在诊断特殊类型的 ALL(如 HAL,My~+ ALL)中具有显著优势;CD19和 CD5诊断 B-ALL 和 T-ALL 的灵敏度较好,但特异性不高,存在抗原交叉表达;CD34和髓系抗原的表达与 CR 率无相关性,但在 HAL,CD34的表达与 CR 率成负相关。     

A case of lymphoproliferative disorder of NK‐cells: aggressive immunophenotype but indolent behavior

Distinguishing chronic lymphoproliferative disorder of NK‐cells from aggressive NK‐cell leukemia is critical because they have distinct clinical course and management. Immunophenotyping plays a key role in distinguishing these two entities, however, it could not be used as sole criteria and clinical/laboratory findings are equally important.     

Current knowledge on the early stages of human neutropoiesis

Polymorphonuclear neutrophils are no longer considered as a homogeneous population of terminally differentiated and short-lived cells that belong to the innate immune system only. In fact, data from the past decades have uncovered that neutrophils exhibit large phenotypic heterogeneity and functional versatility that render them more plastic than previously thought. Hence, their precise role as effector cells in inflammation, in immune response and in other pathophysiological processes, including tumors, needs to be better evaluated. In such a complex scenario, common knowledge of the differentiation of neutrophils in bone marrow refers to lineage precursors, starting from the still poorly defined myeloblasts, and proceeding sequentially to promyelocytes, myelocytes, metamyelocytes, band cells, segmented neutrophils, and mature neutrophils, with each progenitor stage being more mature and better characterized. Thanks to the development and utilization of cutting-edge technologies, novel information about neutrophil precursors at stages earlier than the promyelocytes, hence closer to the hematopoietic stem cells, is emerging. Accordingly, this review discusses the main findings related to the very early precursors of human neutrophils and provides our perspectives on human neutropoiesis.