FMOD expression in whole blood aids in distinguishing between chronic lymphocytic leukemia and other leukemic lymphoproliferative disorders. A pilot study.

Abstract

BACKGROUND:

Within the hematopoietic compartment, fibromodulin (FMOD) is almost exclusively expressed in chronic lymphocytic leukemia (CLL) lymphocytes. We set out to determine whether FMOD could be of help in diagnosing borderline lymphoproliferative disorders (LPD).

METHODS:

We established 3 flow cytometry-defined groups (CLL [n = 65], borderline LPD [n = 28], broadly defined as those with CLLflow score between 35 and -20 or discordant CD43 and CLLflow, and non-CLL LPD [n = 40]). FMOD expression levels were determined by standard RT-PCR in whole-blood samples. Patients were included regardless of lymphocyte count but with tumor burden ≥40%.

RESULTS:

FMOD expression levels distinguished between CLL (median 98.5, interquartile range [IQR] 37.8-195.1) and non-CLL LPD (median 0.012, IQR 0.003-0.033) with a sensitivity and specificity of 1. Most borderline LPDs were CD5/CD23/CD200-positive with no loss of B-cell antigens and negative or partial expression of CD43. 16/22 patients with available cytogenetic analysis showed trisomy 12. In 25/28 (89%) of these patients, FMOD expression levels fell between CLL and non-CLL (median 3.58, IQR 1.06-6.21).

DISCUSSION:

This study could suggest that borderline LPDs may constitute a distinct group laying in the biological spectrum of chronic leukemic LPDs. Future studies will have to confirm these results with other biological data. Quantification of FMOD can potentially be of help in the diagnosis of phenotypically complex LPDs.

• Authors: Marc Sorigue, Jordi Junca, Christelle Ferra, Silvia Marce, Neus Ruiz-Xivillé, Laia Pinyol, Marta Cabezon, Andrea Espasa, Diana Dominguez, Laia Lopez-Viaplana, Rocio Ruiz, Joan Buch, Esther Plensa, Silvia-Zdenka Mostacedo, Jessica Aranda, Sara Vergara, Minerva Raya, Isabel Granada, Gustavo Tapia, Jose-Tomas Navarro, Silvia Beà, Lurdes Zamora
• Journal: Cytometry. Part B, Clinical cytometry (Cytometry B Clin Cytom) Vol. 98 Issue 5 Pg. 421-428 (09 2020) ISSN: 1552-4957 [Electronic] United States
• PMID: 32530577 (Publication Type: Journal Article)
• Copyright: © 2020 International Clinical Cytometry Society.

Chemical References

• FMOD protein, human
• Fibromodulin

Topics

• Aged
• Aged, 80 and over
• Cytodiagnosis (methods)
• Diagnosis, Differential
• Female
• Fibromodulin (blood)
• Flow Cytometry (methods)
• Gene Expression Regulation, Neoplastic (genetics)
• Humans
• Leukemia, Lymphocytic, Chronic, B-Cell (blood, pathology)
• Lymphocyte Count
• Lymphoproliferative Disorders (blood, pathology)
• Male