Detection of mature T-cell leukemias by flow cytometry using anti-T-cell receptor V beta antibodies.
A broad array of antibodies directed against the variable (V) region of the T-cell receptor (TCR) beta (V beta) chain has become available in a directly conjugated multicolor format that permits assessment of 19 of 25 V beta families, covering 70% of the normal circulating T-cell repertoire. These antibodies were used to detect expanded T-cell populations in 43 peripheral blood samples submitted for suspected T-cell malignancy. Of 43 samples, 27 were diagnosed as follows: T-cell large granular lymphocyte leukemia, 14 samples; Sézary syndrome, 4 samples; T-cell prolymphocytic leukemia, 5 samples; or T-cell non-Hodgkin lymphoma or T-cell lymphoproliferative disorder not otherwise specified, 4 samples. The remaining 16 samples were determined to be nonneoplastic. All samples were diagnosed before assessment with anti-V beta flow cytometry. By using a cutoff of 1.6 times the upper limit of normal range (ULN) to define malignant restriction of V beta use, pathologic restriction of V beta use was found directly or indirectly in all 27 samples carrying a diagnosis of malignancy and directly in 2 of 16 samples without a diagnosis of malignancy. TCR gene rearrangement studies were used to confirm V beta flow cytometry results. By using a cutoff of 1.6 times the ULN for the detection of malignancy, the antibody panel had a diagnostic sensitivity of 89% for direct detection of pathologic V beta restriction and a specificity of 88%, making it useful for rapid diagnosis of T-cell leukemia.
Beck
Rose C
RC
Division of Pathology and Laboratory Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, USA.
Stahl
Steve
S
O'Keefe
Christine L
CL
Maciejewski
Jaroslaw P
JP
Theil
Karl S
KS
Hsi
Eric D
ED
D000906:Antibodies / Q000276:immunology*; D005434:Flow Cytometry / Q000379:methods*; D015333:Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; D006801:Humans; D015458:Leukemia, T-Cell / Q000175:diagnosis*; D016399:Lymphoma, T-Cell / Q000175:diagnosis; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000276:immunology*; D012680:Sensitivity and Specificity; D012751:Sezary Syndrome / Q000175:diagnosis
D000906:Antibodies; D016693:Receptors, Antigen, T-Cell, alpha-beta