You are here

Correlation of BRAF V600E Mutation in Peripheral Blood Smears of Hairy Cell Leukemia with Morphology and Immunophenotyping

Journal Name:

Publication Year:

Abstract (2. Language): 
Hairy cell leukemia being defined as a mature B-cell lymphoma shows unique clinicopathological, immunophenotype, and genetic alteration features among another mature B-cell malignancy. Although lymphocytes with hairy appearance and co-expression of CD25, CD11c and CD103 markers on B-cells are compatible with hairy cell leukemia, there are some difficulties in differential diagnosis between HCL with its variant and splenic marginal zone lymphoma. The presence of kinase-activating BRAF V600E mutation in classical HCL clone and in no other mature B-cell lymphomas/ leukemia has implication in differential diagnosis. In this study, we evaluated BRAF V600E mutation detection of H&E stained peripheral blood smears by Sanger sequencing method in patients with classical HCL and findings related to morphology and immunophenotype. Peripheral smear review indicated a subpopulation of atypical lymphocytes with villous cytoplasmic projections. By flow cytometry analysis, B-cells represented immunophenotype of CD19+ CD20(bright)+ CD11c+ CD25+ CD103+. Sanger sequencing demonstrated that presence of BRAF V600E mutation in 86.6% (13/15) of analyzed HCL DNA. Hence, gain-of-function mutation of BRAF V600E is detectable in DNA of peripheral blood smear of patients with classical HCL that were evaluated by immunophenotyping. In conclusion, DNA from peripheral blood smear can be used to identify BRAF V600E mutation using Sanger sequencing method in samples with at least 10% HCL clone as supplementary approach to aid in the diagnosis of classical HCL.
143
149

REFERENCES

References: 

[1] Kraut, Eric H. “Clinical manifestations and infectious complications of hairy-cell leukaemia.” Best Practice &
Research Clinical Haematology Vol. 16, No. 1, 2003, pp. 33-40.
[2] Golomb, Harvey M., Daniel Catovsky, and David W. Golde. “Hairy Cell Leukemia: A clinical review based on
71 cases.” Annals of Internal Medicine Vol. 89, No. 5_Part_1, 1978, pp. 677-83.
[3] Clavel, J., et al. “Hairy cell leukaemia, occupation, and smoking.” British Journal of Haematology Vol. 91, No.
1, 1995, pp. 154-61.
[4] Garza-Ledezma, María Alejandra, et al. “Hairy cell leukemia, an uncommon B-cell lymphoid neoplasia.” Medicina
Universitaria Vol. 18, No. 70, 2016, pp. 34-41.
[5] Falini, Brunangelo, and Enrico Tiacci. “Hairy cell leukemia.” The Lymphoid Neoplasms 3rd edition (2010): 471.
[6] Matutes, Estella. “Immunophenotyping and differential diagnosis of hairy cell leukemia.” Hematology/Oncology
Clinics Vol. 20, No. 5, 2006, pp. 1051-63.
[7] Shao, Haipeng, et al. “Distinguishing hairy cell leukemia variant from hairy cell leukemia: development and
validation of diagnostic criteria.” Leukemia Research Vol. 37, No. 4, 2013, pp. 401-09.
[8] Bacal, Nydia Strachman, et al. “Flow cytometry: Immunophenotyping in 48 hairy cell leukemia cases and the
relevance of fluorescence intensity in CDs expression for diagnosis.” Einstein Vol. 5, No. 2, 2007, pp. 123-28.
[9] Gorczyca, Wojciech. “Flow cytometry in neoplastic hematopathology.” Taylor and Francis, London, New York,
2006.
[10] Sausville, Justin E., et al. “Minimal residual disease detection in hairy cell leukemia: comparison of flow
cytometric immunophenotyping with clonal analysis using consensus primer polymerase chain reaction for the
heavy chain gene.” American Journal of Clinical Pathology Vol. 119, No. 2, 2003, pp. 213-17.
[11] Tiacci, Enrico, et al. “BRAF mutations in hairy-cell leukemia.” New England Journal of Medicine Vol. 364, No.
24, 2011, pp. 2305-15.
[12] Tiacci, Enrico, et al. “Targeting mutant BRAF in relapsed or refractory hairy-cell leukemia.” New England
Journal of Medicine Vol. 373, No. 18, 2015, pp. 1733-47.
[13] Chapman, Paul B., et al. “Improved survival with vemurafenib in melanoma with BRAF V600E mutation.” New
England Journal of Medicine Vol. 364, No. 26, 2011, pp. 2507-16.
[14] Cohen, Yoram, et al. “BRAF mutation in papillary thyroid carcinoma.” Journal of the National Cancer
Institute Vol. 95, No. 8, 2003, pp. 625-27.
[15] Tiacci, Enrico, et al. “Simple genetic diagnosis of hairy cell leukemia by sensitive detection of the BRAF-V600E
mutation.” Blood Vol. 119, No. 1, 2012, pp. 192-95.
[16] Stetler-Stevenson, Maryalice. “Flow cytometry in lymphoma diagnosis and prognosis: useful?.” Best Practice &
Research Clinical Haematology Vol. 16, No. 4, 2003, pp. 583-97.
Jafarzadeh, et al. Int J Med Res Health Sci 2017, 6(11): 143-149
149
[17] Dong, Henry Y., et al. “Immunophenotypic analysis of CD103+ B-lymphoproliferative disorders: hairy cell
leukemia and its mimics.” American Journal of Clinical Pathology Vol. 131, No. 4, 2009, pp. 586-95.
[18] Kaleem, Zahid. “Flow cytometric analysis of lymphomas: current status and usefulness.” Archives of Pathology
& Laboratory Medicine Vol. 130, No. 12, 2006, pp. 1850-58.
[19] Chen, Yi-Hua, et al. “Immunophenotypic variations in hairy cell leukemia.” American Journal of Clinical
Pathology Vol. 125, No. 2, 2006, pp. 251-59.
[20] Falini, Brunangelo, Maria Paola Martelli, and Enrico Tiacci. “BRAF V600E mutation in hairy cell leukemia:
from bench to bedside.” Blood Vol. 128, No. 15, 2016, pp. 1918-27.
[21] Grever, Michael R., James S. Blachly, and Leslie A. Andritsos. “Hairy cell leukemia: Update on molecular
profiling and therapeutic advances.” Blood Reviews Vol. 28, No. 5, 2014, pp. 197-203.
[22] Grever, Michael R., et al. “Consensus guidelines for the diagnosis and management of patients with classic hairy
cell leukemia.” Blood 2016, blood-2016.
[23] Arcaini, Luca, et al. “The BRAF V600E mutation in hairy cell leukemia and other mature B-cell
neoplasms.” Blood Vol. 119, No. 1, 2012, pp. 188-91.
[24] Verma, Shalini, et al. “Rapid detection and quantitation of BRAF mutations in hairy cell leukemia using a
sensitive pyrosequencing assay.” American Journal of Clinical Pathology Vol. 138, No. 1, 2012, pp. 153-56.
[25] Szankasi, Philippe, et al. “A quantitative allele-specific PCR test for the BRAF V600E mutation using a single
heterozygous control plasmid for quantitation: a model for qPCR testing without standard curves.” The Journal
of Molecular Diagnostics Vol. 15, No. 2, 2013, pp. 248-54.
[26] Jamuar, Saumya S., et al. “Somatic mutations in cerebral cortical malformations.” New England Journal of
Medicine Vol. 371, No. 8, 2014, pp. 733-43.
[27] Laurini, Javier A., et al. “Investigation of the BRAF V600E mutation by pyrosequencing in lymphoproliferative
disorders.” American Journal of Clinical Pathology Vol. 138, No. 6, 2012, pp. 877-83.
[28] Langabeer, Stephen E., et al. “Incidence of the BRAF V600E mutation in chronic lymphocytic leukaemia and
prolymphocytic leukaemia.” Leukemia Research Vol. 36, No. 4, 2012, pp. 483-84.
[29] Pettirossi, Valentina, et al. “BRAF inhibitors reverse the unique molecular signature and phenotype of hairy cell
leukemia and exert potent antileukemic activity.” Blood Vol. 125, No. 8, 2015, pp. 1207-16.
[30] Blombery, Piers A., et al. “Detection of BRAF mutations in patients with hairy cell leukemia and related
lymphoproliferative disorders.” Haematologica Vol. 97, No. 5, 2012, pp. 780-83.
[31] Bailleux, Caroline, et al. “Successful re-treatment of a relapsed V600E mutated HCL patient with low-dose
vemurafenib.” Oncoscience Vol. 2, No. 1, 2015, p. 44.
[32] Sosman, Jeffrey A., et al. “Survival in BRAF V600–mutant advanced melanoma treated with vemurafenib.” New
England Journal of Medicine Vol. 366, No. 8, 2012, pp. 707-14.
[33] Dietrich, Sascha, et al. “BRAF inhibition in hairy cell leukemia with low-dose vemurafenib.” Blood Vol. 127,
No. 23, 2016, pp. 2847-55.

Thank you for copying data from http://www.arastirmax.com