Avaliação da heterogeneidade celular nas doenças linfoproliferativas crônicas de células B

Abstract

Introduction: Chronic lymphoproliferative disorders (CLPDs) comprise a group of malignant neoplasms of the hematopoietic system characterized by clinical, morphological, and immunological diversity, potentially involving B lymphocytes, T lymphocytes, and Natural Killer (NK) cells. Within this context, B-cell chronic lymphoproliferative disorders (CLPD-B) are the most prevalent, exhibiting distinct clinical, molecular, and evolutionary features. Due to this heterogeneity, accurate evaluation of these entities represents a clinical challenge. Objectives: To assess cellular heterogeneity through the analysis of immunophenotyping data from reports issued to patients diagnosed with different CLPD-B subtypes. Methods: A retrospective study using immunophenotyping data from 59 CLPD-B cases diagnosed between August 2022 and December 2023 at the Dalton Barbosa Cunha Hemocenter Flow Cytometry Laboratory (HEMONORTE). Data files were processed using the flowCore and tidyverse libraries in R (4.1.1) and RStudio (1.6.0). The JaMovi software (2.6.13) was employed for statistical analysis of the variables contained in the data matrix. Results: The results revealed distinct antigenic marker expression patterns among the studied CLPD-B subtypes, highlighting elevated levels of CD103 and CD123 in the diagnostic group classified as Hairy Cell Leukemia (HCL), as well as restricted Kappa light chain expression in cases diagnosed as CLPD-B and Mantle Cell Lymphoma (MCL) compared to HCL and Chronic Lymphocytic Leukemia (CLL). Additionally, CD5 expression demonstrated its relevance in CLL and MCL, contrasting with low levels in CLPD-B and HCL. Discussion: The findings align with the literature regarding the importance of markers such as CD103 and CD123 in the identification of HCL and CD5 in characterizing CLL and MCL. The observed variability among diagnostic groups reflects phenotypic heterogeneity, essential for precise differential diagnoses. Conclusion: Overall, this study reinforces the literature on CLPD-B, presenting a differential approach and highlighting the importance of integrated analysis of immunophenotypic data in diagnostic practice