A novel scoring system combining expression of CD23, CD20, and CD38 with platelet count predicts for the presence of the t(11;14) translocation of mantle cell lymphoma

Patrick G. Medd, Nithiya Clark, Kevin Leyden, Susan Turner, Jennifer A. Strefford, Caroline Butler, Graham P. Collins, David J. Roberts, Wale Atoyebi, Chris S.R. Hatton

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Background: Both chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) are CD5/19 positive. The t(11;14) MCL translocation is identified by fluorescent in situ hybridization (FISH) and can distinguish the two disorders. We attempted to identify flow cytometric and other markers predictive of a positive FISH test. Methods: We examined 100 atypical CLL/MCL cases for demographic, hematological, and cytometric variables, 96 were FISH tested for t(11;14) and four were known MCL. Results: Twenty-two cases were confirmed as MCL. Multivariate analysis identified four variables associated with MCL: Thrombocytopenia (taken as Plt < 150 × 109/L), CD23 negative, CD20 strong, and CD38 positive, with these variables a four-point score was devised. By ROC analysis, the MCL score was superior in differentiating MCL to the Marsden CLL score (AUC 0.95 vs. 0.78). MCL score ≥2 showed sensitivity 1, specificity 0.66, positive predictive value (PPV) 0.49, and negative predictive value (NPV) 1 for MCL. The score was then prospectively validated on an independent cohort of 44 cases of atypical CLL/MCL. No MCL had a score <3. Validation PPV/NPV of score ≥3 were 0.5/1. Overall survival in MCL was shorter compared to t(11;14) negative patients (median 3.3 vs. 4.2 years, HR 2.2, 95% CI 0.87-5.5, P = 0.1). Conclusions: The score described can be used to identify cases of CD5/19 positive lymphoproliferative disorders likely to be t(11;14) positive MCL.

Original languageEnglish
Pages (from-to)230-237
Number of pages8
JournalCytometry Part B - Clinical Cytometry
Volume80 B
Issue number4
DOIs
Publication statusPublished - Jul 2011
Externally publishedYes

Keywords

  • CD20
  • CD23
  • CD38
  • FISH
  • mantle cell lymphoma
  • screening
  • thrombocytopenia

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