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Previous issue date: 2010-02-24 / Chronic lymphocytic leukemia (B-CLL) is a clonal proliferation of mature B lymphocytes
characterized by indolent clinical course. Biologically this clonallity is characterized by low
expression of surface immunoglobulin (sIg) with restriction to a single immunoglobulin light
chain associated with high expression of CD5 antigen and positivity to B cell antigens
lymphocytes such as CD19, CD20 and CD23 and negativity to FMC7. The immunological
profile and morphological analysis of lymphoid cells are the main means for the differential
diagnosis of B-CLL from other chronic lymphoproliferative diseases. The aim of this study
was to evaluate the expression pattern of a variety of membrane antigens in leukemic cells
originating from patients with B-CLL. In this study, peripheral blood samples from 80
patients with B-CLL were analyzed by multiparametric flow cytometry in addition to routine
hematologic exams, using a panel of monoclonal antibodies (MoAb): CD45/CD14,
CD3/CD19/CD45, CD4/CD8 / CD3, CD20/CD5/CD3, CD3/CD16-56/CD45, CD2/CD7,
FMC7/CD23, CD103/CD22/CD20, HLADR/CD38, CD10/CD19, CD1a, CD11b and also
IgM/gD, kappa and lambda immunoglobulin light chains for the detection of surface
immunoglobulin and clonal restriction for immunoglobulin light chain. The Hematological
data were obtained from the hematological analyzer and cytomorphological analysis in blood
film stained by Leishmann. The study samples consisted of 45 men and 35 women, ages
ranging from 55 to 84 years (mean 65 years). Complete white blood count showed count
ranging from 10.0 to 42.0 x 109/l. (mean 50.0 x 109/l) and lymphocytes count greater than 5.0
x 109/l in all cases. The neoplastic cells displayed B-CLL phenotype
(CD5+/CD19+/CD20+/HLADR+/CD23+) in the vast majority of the cases, associated to
failed to stain for T cell markers (CD1a, CD2, CD4, CD3, CD7, CD8), CD103, CD14 and
FMC7. Leukemic cells of most patients also expressed low intensity of IgM and IgD with
restricted kappa light chain, in most cases (59,7%). This observation highlights the
importance of immunophenotyping for correct diagnosis of chronic lymphoproliferative
syndromes and the panel of MoAb used was sufficient for diagnostic confirmation of B-CLL / A leucemia linfoc?tica cr?nica (LLC-B) ? uma prolifera??o clonal de linf?citos B maduros
caracterizada por curso cl?nico indolente. Biologicamente esta clonalidade ? caracterizada
pela baixa express?o de imunoglobulina de superf?cie (sIg) com restri??o a uma ?nica cadeia
leve de imunoglobulina, associada a alta express?o do ant?geno CD5 e positividade a
ant?genos relacionados a linf?citos B tais como: CD19, CD20 e CD23 e negatividade ao
FMC7. O perfil imunol?gico e a an?lise morfol?gica das c?lulas linf?ides s?o os principais
meios para o diagn?stico diferencial LLC-B de outras doen?as linfoproliferativas cr?nicas. O
objetivo deste estudo foi avaliar o padr?o de express?o de uma variedade de ant?genos de
membrana em c?lulas leuc?micas procedentes de pacientes com LLC-B. No presente estudo,
amostras de sangue perif?rico de 80 pacientes com LLC-B foram analisados por citometria de
fluxo multiparam?trica juntamente com an?lises hematol?gicas de rotina, com um painel de
anticorpos monoclonais (AcMo): CD45/CD14, CD3/CD19/CD45, CD4/CD8/CD3,
CD20/CD5/CD3, CD3/CD16-56/CD45, CD2/CD7, FMC7/CD23, CD103/CD22/CD20,
HLADR/CD38, CD10/CD19, CD1a, CD11b al?m de IgM/gD, e cadeias leves das
imunoglobulinas kappa e lambda visando a detec??o sIg e do perfil de restri??o clonal das
cadeia leves das imunoglobulinas. Os dados hematol?gicos foram obtidos a partir do
analisador hematol?gico e as an?lises citomorfologicas em distens?o sangu?nea coradas pelo
Leishmann. As amostras deste estudo foram procedentes de 45 homens e 35 mulheres, com
idade variando entre 55 e 84 anos (m?dia de 65 anos). O hemograma revelou contagem total
de c?lulas branca variando de 10,0-42,0 x 109/l. (m?dia de 50,0 x 109/l) e contagem de
linf?citos superior a 5,0 x 109/l em todos os casos. As c?lulas neopl?sicas demonstraram um
fen?tipo caracter?stico para LLC-B (CD5+/CD19+/CD20+/HLADR+/CD23+) na maioria dos
casos, associados ? aus?ncia de express?o para marcadores de c?lulas T (CD1a, CD2, CD4,
CD3, CD7, CD8), CD103, CD14 e FMC7. As c?lulas leuc?micas da maioria dos pacientes
expressaram tamb?m IgM e IgD de baixa intensidade com predom?nio da restri??o da cadeia
leve kappa, na maioria dos casos (59,7%). A presente observa??o destaca a import?ncia da
imunofenotipagem para o correto diagn?stico das s?ndromes linfoproliferativas cr?nicas e
sendo o painel de AcMo utilizado capaz de estabelecer a confirma??o diagn?stica da B-CLL
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/13457 |
| Date | 24 February 2010 |
| Creators | Lopes, Maria Cleide de Araujo |
| Contributors | CPF:10861203453, http://lattes.cnpq.br/0091662650633339, Sales, Val?ria Soraya de Farias, CPF:25069144472, http://lattes.cnpq.br/8525532896559374, Alves, Carlos Roberto, CPF:69898448768, Cavalcanti J?nior, Geraldo Barroso |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Ci?ncias Farmac?uticas, UFRN, BR, Bioan?lises e Medicamentos |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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