CLL in "transformation" ?

This very unusual plot of a malignancy (left) shows a narrow scatter profile with highly variable cell volume characteristics.The image on the right is a typical CLL scatterplot for comparison.
Phenotypic analysis on both blood and bone marrow revealed two similar but distinct populations.

Major phenotype on all cells - CD 5/19/20/22/23/Lambda++/FMC7 neg
Minor phenotype showed the same profile with the additional expression of CD 6 and 11a - which in the peripheral blood constituted 54% of CD19+ cells, but in the bone marrow only 13%.
Such a strong expression of light chains is not typical of CLL, however.
Although relatively rare in Oman, the CLL cases phenotyped here invariably showed that CD6 and CD22 were reciprocal in that, if CD6 was present as in a "classic" CLL, then CD22 was absent.

Analysis of Forward scatter vs CD6 and CD11a indicated that the minor phenotype corresponded to the small typical CLL cells seen on morphological examination.

Shown below is the histogram of CD5 vs CD6 gated on CD19+ cells.

---

Back to the index...