Flow Cytometry of CD5-Positive Hairy Cell Leukemia

Diana Cenariu, Ioana Rus, Jón Þór Bergþórsson, Ravnit Grewal, Mihai Cenariu, Victor Greiff, Adrian Bogdan Tigu, Delia Dima, Cristina Selicean, Bobe Petrushev, Mihnea Zdrenghea, Jonathan Fromm, Carmen Mariana Aanei, Ciprian Tomuleasa*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background and Objective: Hairy cell leukemia (HCL) is a chronic lymphoproliferative disorder for which diagnosis is typically straightforward, based on bone marrow morphology and flow cytometry (FC) or immunohistochemistry. Nevertheless, variants present atypical expressions of cell surface markers, as is the case of CD5, for which the differential diagnosis can be more difficult. The aim of the current paper was to describe diagnosis of HCL with atypical CD5 expression, with an emphasis on FC. Methods: The detailed diagnostic methodology for HCL with atypical CD5 expression is presented, including differential diagnosis from other lymphoproliferative diseases with similar pathologic features, by FC analysis of the bone marrow aspirate. Results: Diagnosis of HCL by means of FC started by gating all events based on side scatter (SSC) versus CD45 and B lymphocytes were selected from the lymphocytes gate as CD45/CD19 positive. The gated cells were positive for CD25, CD11c, CD20, and CD103, while CD10 proved to be dim to negative. Moreover, cells positive for CD3, CD4, and CD8, the three pan-T markers, as well as CD19, showed a bright expression of CD5. The atypical CD5 expression is usually correlated with a negative prognosis and thus chemotherapy with cladribine should be initiated. Conclusion: HCL is an indolent chronic lymphoproliferative disorder and diagnosis is usually straightforward. However, atypical expression of CD5 renders its differential diagnosis more difficult, but FC is a useful tool that allows an optimal classification of the disease and allows initiation of timely satisfactory therapy.

Original languageEnglish
Pages (from-to)593-599
Number of pages7
JournalMolecular Diagnosis and Therapy
Issue number5
Publication statusPublished - Sept 2023

Bibliographical note

Funding Information:
Diana Cenariu, Mihai Cenariu, Jon Thor Bergthorsson, and Victor Greiff are financed by an international collaborative grant of the European Economic Space between Romania, Iceland, and Norway 2014–2021 (Grant no 21-COP-0034). Diana Cenariu also received funding from a grant of the National Research Ministry of Romania - PN-III-P4-ID-PCE-2020-1118.

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature Switzerland AG.


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