HCL | FlowcytometryNet
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Hairy-cell leukemia (HCL)

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Hairy-cell leukemia (HCL) is a malignant disease which affects the B lymphocytes and belongs to the indolent lymphomas. The name is derived from the microscopical aspect of leukemic cells which display characteristic, fine cytoplasmic projections .Hairy-cell leukemia is a rare disease. Its incidence is approximately 0.3/100,000 people. The median average age lies between 50 to 55 years. The age interval is very broad, however, children are not affected. The disease occurs up to five times more often in males than in females .

Two forms of the disease are hairy-cell leukemia (HCL) and a variant (HCL-V) . The variant form of hairy-cell leukemia (HCL-V) differs with regard to its cytology, immunology, and cytochemistry. HCL-V is typically accompanied by a leukocytosis, with cell counts ranging from 15,000 to 400,000 /µl. The morphology of these cells displays a central nucleus with dense chromatin and a prominent nucleolus. The cells underexpress 3p24, 3p21, 3q13.3-q22, 4p16, 11q23, 14q22-q24, 15q21-q22, 15q24-q25, and 17q22-q24 and overexpress 13q31 and Xq13.3-q21.

 

Immunophenotype :

These cells are bright CD20, CD11c and surface immunoglobulins (kappa or lambda). CD25, CD11c and CD103 are coexpressed on these cells. CD25 can be negative in a subset of HCL variants (HCLv). Occassionally, an aberrant phenotype is expressed. The expression of CD103 may vary.

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Case-1

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Above case shows positivity for CD19,CD20, CD103, CD11c, CD25, FMC-7 and negativity for CD5, CD23, CD3

 

 

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References

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  • Yam LT, Janckila AJ, Li CY, Lam WKW. Cytochemistry of tartrate-resistant acid-phosphatase: 15 years' experience. Leukemia 1987;1:285–288.[PubMed]

  • Sausville JE, Salloum RG, Sorbara L, et al. Minimal residual disease detection in hairy cell leukemia. Comparison of flow cytometric immunophenotyping with clonal analysis using consensus primer polymerase chain reaction for the heavy chain gene. Am J Clin Pathol 2003;119:213–217.[PubMed]

  • Cessna M, Hartung L, Tripp S, Perkins SL, Bahler DW. Hairy cell leukemia variant: fact or fiction. Am J Clin Pathol 2005; 123:132–138. [PubMed]

  • Forconi F, Sozzi E, Rossi D, et al. Selective influences in the expressed immunoglobulin heavy and light chain gene repertoire in hairy cell leukemia. Haematologica 2008;93:697–705.[PubMed]

  • Chen YH, Tallman MS, Goolsby C, Peterson L. Immunophenotypic variations in hairy cell leukemia. Am J Clin Pathol 2006;125:251–259. [PubMed]

  • Del Giudice I, Matutes E, Morilla R, et al. The diagnostic value of CD123 in B-cell disorders with hairy or villous lymphocytes. Haematologica 2004;89:303–308.[PubMed]

  • Dong HY, Weisberger J, Liu Z, Tugulea S. Immunophenotypic analysis of CD103+ B-lymphoproliferative disorders: hairy cell leukemia and its mimics. Am J Clin Pathol 2009;131:586–595. [PubMed]

  • Bouroncle BA, Wiseman BK, Doan CA. Leukemic reticuloendotheliosis.Blood.1958;13(7):609-630.

  • Quesada JR, Reuben J, Manning JT, Hersh EM,Gutterman JU. Alpha interferon for induction of remission in hairy-cell leukemia.N Engl J Med. 1984;310(1):15-18.

  • Spiers AS, Parekh SJ, Bishop MB. Hairy-cell leukemia: induction of complete remission with pentostatin (2-deoxycoformycin).J Clin Oncol.1984;

  • 2(12):1336-1342.

  • Kraut EH, Bouroncle BA, Grever MR. Low-dosedeoxycoformycin in the treatment of hairy cell leukemia.Blood.1986;68(5):1119-1122.

  • Kraut EH, Grever MR, Bouroncle BA. Long-term follow-up of patients with hairy cell leukemia after treatment with 2-deoxycoformycin.

  • Blood.1994;84(12):4061-4063.

  • Johnston JB, Eisenhauer E, Corbett WE, Scott JG, Zaentz SD. Efficacy of 2-deoxycoformycin in hairy-cell leukemia: a study of the National Can-

  • cer Institute of Canada Clinical Trials Group. J Natl Cancer Inst. 1988;80(10):765-769.

  • Grever M, Kopecky K, Foucar MK, et al. Randomized comparison of pentostatin versus interferonalfa-2a in previously untreated patients with hairy

  • cell leukemia: an intergroup study.J Clin Oncol.1995;13(4):974-982.

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