Background: At present, the diagnosis of lymphoproliferative disorders is based on the combination of blood or bone marrow smear morphology and immunophenotyping by flow cytometry. Immunophenotypic testing by flow cytometry technique is available only in big medical centers, which is not always convenient for a patient. Therefore, development of an available method for preliminary diagnosis of lymphoproliferative diseases not requiring special equipment seems relevant.Materials and methods: Peripheral blood mononuclear cells from 17 patients admitted to the hospital with suspicion of a lymphoproliferative disorder, and 17 healthy donors were studied on a cell biochip for determination of proportions of cells positive for various surface CD antigens. The diagnosis was verified by flow cytometry.Results: Compared to healthy controls and patients with T-cell lymphoproliferative disorders (TCLPD), the patients with B-cell lymphoproliferative disorders (BCLPD) had significantly lower proportion of CD7+ cells (medians, 7% and 73% respectively, p=2×10-6 for comparison with healthy controls; median 7% and 93% for comparison with TCLPD, p=0.032). In addition, the patients with BCLPD had higher proportion of peripheral СD19+ mononuclear cells, compared to that in the patients with TCLPD and healthy donors (medians 84% and 13% for comparison between BCLPD and healthy control, p=2×10-5; 84% and 3% for comparison of BCLPD and TCLPD, p=0.033). The patients with B-cell chronic lymphocytic leukemia had significantly higher CD5+ cells in the cell biochip compared to the patients with other BCLPD (medians 72% and 9%, p=0.024). The patients with TCLPD had significantly lower proportion of CD19+ cells than the healthy controls (medians, 3% and 13%, respectively, р=0.042).Conclusion: The study has demonstrated the potential to use the previously developed cell biochip for diagnosis of lymphoproliferative diseases. The biochip makes it possible to sort out white blood cells according to their surface differentiation antigen for their further morphological analysis. The cell biochip allows for the differential diagnosis between BCLPD and TCLPD and determination the lymphocyte clones based on the expression of immunoglobulin light chains.

Both the ratio of different leukocyte subgroup content and the leukocyte morphology in peripheral blood of newborns are important in diagnosis of several diseases including combined immunodeficiency and neonatal septicemia. There is a need for development of screening methods for parallel study of the leukocyte morphology and population structure in the newborn peripheral blood. We aimed to determine the relative abundance of different leukocyte subsets and to study their morphology in full-term and premature newborn babies and healthy adult volunteers using the cell-binding microarray – a transparent support with immobilized antibodies against leukocyte cluster-of-differentiation antigens. The work was supported by the Scientific council and approved by the ethical committee of the Centre. We have studied the peripheral blood of 12 full-term newborns (38–40 weeks gestation), 9 premature newborns (22–32 weeks gestation) and 18 healthy adults. The relative abundance of the leukocyte and their morphology were determined using the cell-binding microarray including antibodies against CD2, СD3, СD4, CD5, СD7, CD8, CD10, СD11b, CD11c, CD13, CD14, CD15, CD16, CD19, CD20, CD22, CD25, CD33, CD38, CD41a, CD45, CD45RA, CD45RO, CD61, CD64, CD117, CD123, HLA-DR. The percentage of leukocytes positive for every of the studied surface CD antigens among the peripheral blood mononuclear cells of full-term and preterm newborn babies and healthy adults determined on the cell–binding microarray are in good agreement with published flow cytometry data. CD11b+ leukocytes both in premature and full-term newborns included up to 21% myelocytes and 27% metamyelocytes. The reported data can be used as reference values in cell-binding microarray application in diagnosis of combined immunodeficiency or neonatal septicemia.

The paper deals with a combined case of hairy cell leukemia and lymphoplasmacytic lymphoma with IgMκ paraprotein secretion. The use of anti-CD antibody microarray enabled the simultaneous assessment of immunophenotype as well as morphological and cytochemical analysis. Small populations of hairy (3 % of total lymphocyte count) and plasma (2 %) cells including Mott cells (0.2 %) were found in the peripheral blood of a patient with leukopenia. The results obtained by the anti-CD antibody microarray method speeded up provisional diagnosis which was later confirmed by standard diagnostic methods.

Hairy cell leukemia (HCL) is a chronic lymphoproliferative disorder constituting about 2% from all leukemia cases and characterized by typical “hairy” morphology of tumor lymphocytes. We describe an HCL case with atypical nuclear shapes (lymphocytes with clover-leaf-like, horse-shoe-like, ring-shaped nuclei and binuclear cells were present). Morphology and immunophenotype of circulating leukemic cells were studied using a cell-binding microarray - a transparent plastic slide with immobilized monoclonal antibodies against surface antigens of lymphocytes. The cell-binding microarray with immobilized anti-CD11c, anti-CD103 and anti-CD123 permits to study a lymphocyte population enriched with hairy cells. Hairy cells with atypical nuclei constituted 3% of all lymphocytes and 15% of all hairy cells. This unusual hairy cell morphology is the first described in Russia and was found in one out of 85 HCL cases in our practice.

Key Clinical MessageThe morphologic diagnosis of hairy cell leukemia coexisting with another lymphoproliferative disorder is hindered by the small size of hairy cell population. It can be simplified by presorting peripheral blood mononuclear cell using an anti‐CD antibody microarray on transparent support (including anti‐CD11c, CD25, CD103, and CD123) before their morphology analysis.

We have studied the morphology and immunophenotype of circulating tumor cells isolated from peripheral blood of 22 patients with splenic marginal zone lymphoma and show that both of them are highly heterogeneous. Using a cell-binding microarray we have demonstrated that the circulating lymphoma cells are positive for CD19 (100 %), CD20 (100 %), CD22 (100 %), surface IgM (73 %), CD38 (23 %), CD5 (9 %), CD11c (36 %), CD103 (5 %), CD25 (32 %), CD23 (23 %) and these immunophenotypes are confirmed in all cases by flow cytometry.Higher surface density of lymphocyte binding onto anti-CD antibody microarray spots compared to blood smears permits to find circulating lymphoma cells even in leukopenic patients.

Here we describe and qualitatively characterize the distribution of mononuclear cells isolated from bone marrow aspirate of healthy donors and sorted by their surface CD antigens on a cell microarray by morphology (for 11 donors) and by absence or presence of α-naphthyl butyrate esterase and naphthol AS-D chloroacetate esterase (for 9 donors). These data can be used as a reference for the diagnosis of acute myeloid leukemia using the cell microarray.

AIMTo generalize hematologists' experience of the diagnosis and differential diagnosis of splenic red pulp lymphoma (SRPL).MATERIAL AND METHODSEighty-seven splenic biopsy specimens taken from patients with different B-cell lymphoproliferative diseases were examined in the Hematology Research Center in 2013-2014. The diagnosis of SRPL was based on the morphological, immunohistochemical, immunophenotypic, and molecular examinations of the splenic biopsy specimens, blood and bone marrow (BM) tests in 4 (4.6%) cases.RESULTSThere was significant splenomegaly in all SRPL cases, lymphocytosis in 56 to 94% (leukocytes, 55 and 75·109/l in 2 cases), circulation of hairy lymphocytes with the phenotypes CD20+ (markedly), CD11c+/±, CD103+/± (weakly), LAIR-1+, CD25-, CD5-, CD10-, and CD23-, which did not contain tartate-resistant acid phosphatase, without BRAFV600E mutation, BM with insignificant lymphoid infiltration of CD20+, CD25-, Annexin 1-, and Cyclin D1-. The weight of the spleen averaged 3900 g (1450-9500 g); its tissue exhibited lymphoid infiltration of the red pulp with the phenotypes CD20+, DBA.44+, CD25-, Annexin1-, Cyclin D1-, CD103-, CD123-, CD27-, focal СD11c±, and TRAP±. Four patients (2 after splenectomy (SE) and 2 after SE and chemotherapy with cladribine and rituximab) are being followed up in remission.CONCLUSIONSRPL is a rare disease that should be presumed to be in significant splenomegaly and lymphocytosis with hairy lymphocytes, which have only some markers for classical hairy cell leukemia (HCL), in minor BM lesion. SE is the standard for diagnosis and treatment. The differential diagnosis of SRPL with HCL has clear criteria and that with HCL-v is undetected.

The World Health Organization 2008 classification highlighted a new nosology-splenic diffuse red pulp lymphoma (SDRPL) with clinical and laboratory features similar to both splenic marginal zone lymphoma and hairy cell leukemia (HCL) and variant form of HCL. Experience of hematologists on the diagnosis and differential diagnosis of SDRPL is extremely limited. The aim of our report was to characterize the clinical and immunomorphologic features of SDRPL on our own observations. During 2013-2014, in National Research Center for Hematology, 87 spleen specimens removed from various B-cell lymphomas were analyzed. In four (4.6%) cases, the diagnosis SDRPL was made based on morphologic, immunohistochemical, immunophenotypic, molecular examination of spleen biopsies, blood and bone marrow samples. In all cases of SDRPL were observed significant splenomegaly, lymphocytosis from 56% to 94% (in two cases with leukocytosis 55.000 and 75.000 109/l). The circulating "villous" lymphocytes phenotype was CD20+ (bright), CD11c+/±, CD103 (weakly)+/±, LAIR-1+, CD25-, CD5-, CD10-, and CD23-. Mutation BRAFV600E was not detected. Bone marrow with minor lymphoid CD20+, CD25-, Annexin1-, Cyclin D1- cell infiltration. The average weight of the spleen was 3900 g (1450-9500 g), and morphologically, there was revealed lymphoid infiltration of red pulp with phenotype CD20+, DBA.44+, CD25-, Annexin1-, Cyclin D1-, CD103-, CD123-, CD27-, focal SD11c± and TRAP±. Now patients are observed in remission: two patients after splenectomy, two after splenectomy and cladribine+rituximab chemotherapy. SRDPL-a rare lymphoma that is suspected in the cases with significant splenomegaly and lymphocytosis with villous lymphocytes forms that have only a part of the classic markers HCL, with minor bone marrow infiltration. The standard diagnosis and treatment is splenectomy. Differential diagnosis of SMZL and HCL has clear criteria, but criteria of differentiation with variant HCL are still unknown.

Hairy cell leukemia (HCL), a chronic B-cell lymphoproliferative disease with special villous morphology and immunophenotypic markers of lymphoid cells, is characterized by the involvement of bone marrow and spleen. The paper describes a case of a 29-year-old female patient without abnormal clinical blood tests and myelograms, with normal spleen sizes, in whom the only manifestation of HCL was massive scrotal injury with a soft tissue component in the small pelvic cavity.

WHO 2008 classification highlighted a new nosology – splenic diffuse red pulp lymphoma (SDRPL) with clinical and laboratory features similar both splenic marginal zone lymphoma and with hairy cell leukemia (HCL) and variant form of HCL (V-HCL). Experience of hematologists on diagnosis and differential diagnosis of SDRPL is extremely limited.

We describe a method for leukocyte sorting by a microarray of anti-cluster-of-differentiation (anti-CD) antibodies and for preparation of the bound cells for morphological or cytochemical examination. The procedure results in a “sorted” smear with cells positive for certain surface antigens localised in predefined areas. The morphology and cytochemistry of the microarray-captured normal and neoplastic peripheral blood mononuclear cells are identical to the same characteristics in a smear. The microarray permits to determine the proportions of cells positive for the CD antigens on the microarray panel with high correlation with flow cytometry. Using the anti-CD microarray we show that normal granular lymphocytes and lymphocytes with radial segmentation of the nuclei are positive for CD3, CD8, CD16 or CD56 but not for CD4 or CD19. We also show that the described technique permits to obtain a pure leukemic cell population or to separate two leukemic cell populations on different antibody spots and to study their morphology or cytochemistry directly on the microarray. In cases of leukemias/lymphomas when circulating neoplastic cells are morphologically distinct, preliminary diagnosis can be suggested from full analysis of cell morphology, cytochemistry and their binding pattern on the microarray.

We describe an application of a cell-binding microarray – to parallel study of morphology, tartrate-resistant acid phosphatase activity and detection of surface markers on peripheral blood lymphocytes of 90 atients with suspected hairy cell leukemia (HCL). We have formulated the microarray-based diagnostic criteria for hairy cell leukemia, hairy cell leukemia variant (HCLv) and splenic marginal zone lymphoma (SMZL). According to these criteria we have suggested the presence of HCL for 55 patients, HCLv – for 7 patients and SMZL – for 10 patients from the studied cohort. These diagnoses were confirmed by standard diagnostic methods in all cases. These results show that the cellbinding microarray can be used in differential diagnosis of HCL, while the high sensitivity of the microarray permits to detect the leukemic cells in spite of leukopenia and low hairy cell content.