Downregulation of Lymphoid enhancer‐binding factor 1 (LEF‐1) expression (by immunohistochemistry and/ flow cytometry) in chronic Lymphocytic Leukemia with atypical immunophenotypic and cytologic features. (12th December 2020)

• Record Type: Journal Article
• Authors: Soliman, Dina S.; Al‐Kuwari, Einas; Siveen, Kodappully S; Al‐Abdulla, Rajaa; Chandra, Prem; Yassin, Mohamed; Nashwan, Abdulqader; Hilmi, Feryal A; Taha, Ruba Y; Nawaz, Zafar; El‐Omri, Halima; Mateo, Jericha M; Al‐Sabbagh, Ahmad
• Is Part Of: International journal of laboratory hematology. Volume 43:Number 3(2021)
• Page Start: 515
• Page End: 525
• Publication Date: 2020-12-12
• Subjects: atypical CLL -- Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) -- Flow cytometry -- Immunohistochemistry -- Lymphoid enhancer‐binding factor 1 (LEF‐1); Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Hematology -- Periodicals; 616.15005
• DOI: 10.1111/ijlh.13420
• Languages: English
• ISSNs: 1751-5521

Abstract

Abstract: Introduction: Lymphoid enhancer‐binding factor 1 ( LEF‐1 ) overexpression has been recently remarkably reported in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and has shown utility in distinguishing CLL/SLL from other B‐cell lymphomas. CLL has a well‐defined immunophenotype, yet, some cases of CLL demonstrate atypical morphology/ phenotype reflected by low Matutes score (atypical CLL). Till date, LEF1 expression has not been systematically studied in cases of CLL with atypical features. Methods: In this study, LEF‐1 expression was assessed by two different techniques, (immunohistochemistry and flow cytometry), to investigate the expression profile of LEF‐1 in cases of CLL/SLL, in comparison with other low‐grade B‐lymphomas and CLL with atypical features, including atypical immunophenotype and CLL with increased prolymphocytes or morphologically atypical cells. Results: We found that LEF‐1 expression is downregulated in CLL with atypical immunophenotype/features compared to classic CLL; Chi‐Square P < .0001. The ratio for LEF‐1 expression in malignant B‐cells/NK (by flow cytometry) in CLL/SLL with classic immunophenotype was higher than atypical CLL and is significantly higher in other small B‐cell lymphomas ( P < .01). Absence of LEF‐1 expression in CLL/SLL is correlated ( P < .05) with downregulation of CD5, CD23, CD200, expression of FMC7, brighter expression of CD79b, brighter expression of surface light chain, increased prolymphocytes and lower Matutes score. Conclusion: As downregulation of LEF‐1 expression is well correlated with atypical CLL, we suggest adding LEF‐1 to Matutes score as a beneficial marker to differentiate classic from atypical CLL LEF‐1 could also serve as a potential prognostic indicator for CLL clinical course.