False-Positive Light Chain Clonal Restriction by Flow Cytometry in Patients Treated With Alemtuzumab: Potential Pitfalls for the Misdiagnosis of B-Cell Neoplasms
To increase awareness of potential diagnostic test interference associated with alemtuzumab, which is a therapeutic immunoglobulin G1 κ monoclonal antibody used in hematologic malignancies, autoimmune diseases, and transplant-related disorders. Bone marrow and blood from patients with T-cell prolymp...
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| Veröffentlicht in: | American journal of clinical pathology 2019-02, Vol.151 (2), p.154-163 |
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| container_title | American journal of clinical pathology |
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| creator | Chen, Peter P Tormey, Christopher A Eisenbarth, Stephanie C Torres, Richard Richardson, Susan S Rinder, Henry M Smith, Brian R Siddon, Alexa J |
| description | To increase awareness of potential diagnostic test interference associated with alemtuzumab, which is a therapeutic immunoglobulin G1 κ monoclonal antibody used in hematologic malignancies, autoimmune diseases, and transplant-related disorders.
Bone marrow and blood from patients with T-cell prolymphocytic leukemia treated with alemtuzumab were evaluated by flow cytometry. Healthy donor blood was analyzed with or without in vitro treatment with alemtuzumab for comparison.
Immunophenotypic analysis of bone marrow collected 4 weeks after alemtuzumab treatment demonstrated artifactual surface κ light chain restriction in CD19+ B cells and CD3+ T cells. Similar findings were observed in blood from another patient in a specimen collected 3 days after alemtuzumab treatment. These findings were recapitulated in healthy donor blood incubated with alemtuzumab.
Alemtuzumab can produce direct interference during flow cytometry analysis, resulting in false-positive evidence of light chain clonality. Clinicians and laboratorians should be cognizant of this risk to avoid misdiagnosis of B-cell neoplasms. |
| doi_str_mv | 10.1093/ajcp/aqy129 |
| format | Article |
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Bone marrow and blood from patients with T-cell prolymphocytic leukemia treated with alemtuzumab were evaluated by flow cytometry. Healthy donor blood was analyzed with or without in vitro treatment with alemtuzumab for comparison.
Immunophenotypic analysis of bone marrow collected 4 weeks after alemtuzumab treatment demonstrated artifactual surface κ light chain restriction in CD19+ B cells and CD3+ T cells. Similar findings were observed in blood from another patient in a specimen collected 3 days after alemtuzumab treatment. These findings were recapitulated in healthy donor blood incubated with alemtuzumab.
Alemtuzumab can produce direct interference during flow cytometry analysis, resulting in false-positive evidence of light chain clonality. Clinicians and laboratorians should be cognizant of this risk to avoid misdiagnosis of B-cell neoplasms.</description><identifier>ISSN: 0002-9173</identifier><identifier>EISSN: 1943-7722</identifier><identifier>DOI: 10.1093/ajcp/aqy129</identifier><identifier>PMID: 30307483</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Autoimmune diseases ; Blood ; Bone marrow ; Bone marrow transplantation ; Case studies ; Causes of ; CD19 antigen ; CD3 antigen ; Diagnosis ; Drug therapy ; False positive reactions ; Flow cytometry ; Immunoglobulin G ; Immunotherapy ; Leukemia ; Lymphocytes B ; Lymphocytes T ; Lymphomas ; Medical research ; Medicine, Experimental ; Monoclonal antibodies ; Targeted cancer therapy</subject><ispartof>American journal of clinical pathology, 2019-02, Vol.151 (2), p.154-163</ispartof><rights>COPYRIGHT 2019 Oxford University Press</rights><rights>American Society for Clinical Pathology, 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30307483$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Peter P</creatorcontrib><creatorcontrib>Tormey, Christopher A</creatorcontrib><creatorcontrib>Eisenbarth, Stephanie C</creatorcontrib><creatorcontrib>Torres, Richard</creatorcontrib><creatorcontrib>Richardson, Susan S</creatorcontrib><creatorcontrib>Rinder, Henry M</creatorcontrib><creatorcontrib>Smith, Brian R</creatorcontrib><creatorcontrib>Siddon, Alexa J</creatorcontrib><title>False-Positive Light Chain Clonal Restriction by Flow Cytometry in Patients Treated With Alemtuzumab: Potential Pitfalls for the Misdiagnosis of B-Cell Neoplasms</title><title>American journal of clinical pathology</title><addtitle>Am J Clin Pathol</addtitle><description>To increase awareness of potential diagnostic test interference associated with alemtuzumab, which is a therapeutic immunoglobulin G1 κ monoclonal antibody used in hematologic malignancies, autoimmune diseases, and transplant-related disorders.
Bone marrow and blood from patients with T-cell prolymphocytic leukemia treated with alemtuzumab were evaluated by flow cytometry. Healthy donor blood was analyzed with or without in vitro treatment with alemtuzumab for comparison.
Immunophenotypic analysis of bone marrow collected 4 weeks after alemtuzumab treatment demonstrated artifactual surface κ light chain restriction in CD19+ B cells and CD3+ T cells. Similar findings were observed in blood from another patient in a specimen collected 3 days after alemtuzumab treatment. These findings were recapitulated in healthy donor blood incubated with alemtuzumab.
Alemtuzumab can produce direct interference during flow cytometry analysis, resulting in false-positive evidence of light chain clonality. Clinicians and laboratorians should be cognizant of this risk to avoid misdiagnosis of B-cell neoplasms.</description><subject>Autoimmune diseases</subject><subject>Blood</subject><subject>Bone marrow</subject><subject>Bone marrow transplantation</subject><subject>Case studies</subject><subject>Causes of</subject><subject>CD19 antigen</subject><subject>CD3 antigen</subject><subject>Diagnosis</subject><subject>Drug therapy</subject><subject>False positive reactions</subject><subject>Flow cytometry</subject><subject>Immunoglobulin G</subject><subject>Immunotherapy</subject><subject>Leukemia</subject><subject>Lymphocytes B</subject><subject>Lymphocytes T</subject><subject>Lymphomas</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Monoclonal antibodies</subject><subject>Targeted cancer therapy</subject><issn>0002-9173</issn><issn>1943-7722</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNptkVGL1DAUhYMo7jj65LsEfPGlu0nTNolvY3FUGHWQFR9Lmt7MZEib2SRV6r_xn5rFFVEkcAPhu-eenIvQU0ouKZHsSp30-UrdLLSU99CKyooVnJflfbQihJSFpJxdoEcxngihpSDVQ3TBCCO8EmyFfmyVi1DsfbTJfgW8s4djwu1R2Qm3zk_K4U8QU7A6WT_hfsFb57_hdkl-hBQWnLm9ShamFPF1AJVgwF9sOuKNgzHN3-dR9S_x3qdM2Ky2t8ko5yI2PuB0BPzexsGqw5QdROwNflW04Bz-AP7sVBzjY_TA3Hp8cnev0eft6-v2bbH7-OZdu9kVh5I1qVBGaMNgaEzNRV9pTdhAONQy56GJEbJuhqFmBAbIqSmiFde95H1jes4ElWyNXvzSPQd_M-c_d6ONOltRE_g5diWlghEhcl2j5_-gJz-HnFWmWMOkqLks_1AH5aCzk_EpKH0r2m2aSuTd0Jpk6vI_VD4DjFb7CYzN7381PLsbPvcjDN052FGFpfu9U_YTmJWj5g</recordid><startdate>20190201</startdate><enddate>20190201</enddate><creator>Chen, Peter P</creator><creator>Tormey, Christopher A</creator><creator>Eisenbarth, Stephanie C</creator><creator>Torres, Richard</creator><creator>Richardson, Susan S</creator><creator>Rinder, Henry M</creator><creator>Smith, Brian R</creator><creator>Siddon, Alexa J</creator><general>Oxford University Press</general><scope>NPM</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20190201</creationdate><title>False-Positive Light Chain Clonal Restriction by Flow Cytometry in Patients Treated With Alemtuzumab: Potential Pitfalls for the Misdiagnosis of B-Cell Neoplasms</title><author>Chen, Peter P ; Tormey, Christopher A ; Eisenbarth, Stephanie C ; Torres, Richard ; Richardson, Susan S ; Rinder, Henry M ; Smith, Brian R ; Siddon, Alexa J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g236t-af8cf3ed6f578b4cc03d07e59943c0f8956dd530ede109a0ca7cb97b6fb738193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Autoimmune diseases</topic><topic>Blood</topic><topic>Bone marrow</topic><topic>Bone marrow transplantation</topic><topic>Case studies</topic><topic>Causes of</topic><topic>CD19 antigen</topic><topic>CD3 antigen</topic><topic>Diagnosis</topic><topic>Drug therapy</topic><topic>False positive reactions</topic><topic>Flow cytometry</topic><topic>Immunoglobulin G</topic><topic>Immunotherapy</topic><topic>Leukemia</topic><topic>Lymphocytes B</topic><topic>Lymphocytes T</topic><topic>Lymphomas</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Monoclonal antibodies</topic><topic>Targeted cancer therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Peter P</creatorcontrib><creatorcontrib>Tormey, Christopher A</creatorcontrib><creatorcontrib>Eisenbarth, Stephanie C</creatorcontrib><creatorcontrib>Torres, Richard</creatorcontrib><creatorcontrib>Richardson, Susan S</creatorcontrib><creatorcontrib>Rinder, Henry M</creatorcontrib><creatorcontrib>Smith, Brian R</creatorcontrib><creatorcontrib>Siddon, Alexa J</creatorcontrib><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of clinical pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Peter P</au><au>Tormey, Christopher A</au><au>Eisenbarth, Stephanie C</au><au>Torres, Richard</au><au>Richardson, Susan S</au><au>Rinder, Henry M</au><au>Smith, Brian R</au><au>Siddon, Alexa J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>False-Positive Light Chain Clonal Restriction by Flow Cytometry in Patients Treated With Alemtuzumab: Potential Pitfalls for the Misdiagnosis of B-Cell Neoplasms</atitle><jtitle>American journal of clinical pathology</jtitle><addtitle>Am J Clin Pathol</addtitle><date>2019-02-01</date><risdate>2019</risdate><volume>151</volume><issue>2</issue><spage>154</spage><epage>163</epage><pages>154-163</pages><issn>0002-9173</issn><eissn>1943-7722</eissn><abstract>To increase awareness of potential diagnostic test interference associated with alemtuzumab, which is a therapeutic immunoglobulin G1 κ monoclonal antibody used in hematologic malignancies, autoimmune diseases, and transplant-related disorders.
Bone marrow and blood from patients with T-cell prolymphocytic leukemia treated with alemtuzumab were evaluated by flow cytometry. Healthy donor blood was analyzed with or without in vitro treatment with alemtuzumab for comparison.
Immunophenotypic analysis of bone marrow collected 4 weeks after alemtuzumab treatment demonstrated artifactual surface κ light chain restriction in CD19+ B cells and CD3+ T cells. Similar findings were observed in blood from another patient in a specimen collected 3 days after alemtuzumab treatment. These findings were recapitulated in healthy donor blood incubated with alemtuzumab.
Alemtuzumab can produce direct interference during flow cytometry analysis, resulting in false-positive evidence of light chain clonality. Clinicians and laboratorians should be cognizant of this risk to avoid misdiagnosis of B-cell neoplasms.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>30307483</pmid><doi>10.1093/ajcp/aqy129</doi><tpages>10</tpages></addata></record> |
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| source | OUP_牛津大学出版社现刊; Alma/SFX Local Collection; EZB Electronic Journals Library |
| subjects | Autoimmune diseases Blood Bone marrow Bone marrow transplantation Case studies Causes of CD19 antigen CD3 antigen Diagnosis Drug therapy False positive reactions Flow cytometry Immunoglobulin G Immunotherapy Leukemia Lymphocytes B Lymphocytes T Lymphomas Medical research Medicine, Experimental Monoclonal antibodies Targeted cancer therapy |
| title | False-Positive Light Chain Clonal Restriction by Flow Cytometry in Patients Treated With Alemtuzumab: Potential Pitfalls for the Misdiagnosis of B-Cell Neoplasms |
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