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Changes in Antigen Expression in a Follow-up of Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Jiehao Zhou, Anupama Tewari, Mehdi Nassiri and Magdalena Czader

Objectives:Diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) depends on specific immunophenotype of select antigens and their characteristic density. However, reports detailing how the expression of specific antigen changes over time of disease course are sparse. Methods: We identified 37 CLL/SLL with initial and follow-up samples studied by flow cytometry. Expression levels of a panel of antigens were compared between initial and follow-up samples from the same patients. Results: There is a significant decrease in the CD23 density and in the percentage of CD23 positive cells, and a decrease in the density of CD5 in the follow-up samples. In contrast, a significant increase in the density of HLA-DR antigen was observed in the follow-up. Conclusion: The expression of selected antigen changes in the course of CLL/SLL. These alterations do not impact the diagnosis of CLL/SLL based on the immunophenotype of follow-up samples and should not influence the ability to determine minimal residual disease by flow cytometry. However, they can potentially influence the responsiveness to the monoclonal antibody therapy and should be further systematically evaluated.