I recently received the results from my bone marrow biopsy and most of it I can understand due to the help of a cousin who is getting her PhD. The one hangup is the part that states "CD45 Negative 2% No significant reactivity with markers tested (may represent unlysed red blood cells, erythroid precursors)."
Is CD45 a marker of progression? Would I want to see CD45 positive on these results?
I understand there are a many other contributing factors here, but I'd just like to understand this one marker.
Thanks so much for your help.
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Re: Bone marrow biopsy results - CD45 negative 2%?
First off, I'm not a doc, so please verify all this with your oncologist.
CD45 is one of many antigens (a protein) that is found on the surface of cells. Cells have unique combinations of these antigens, which determine a cell's "immunophenotype", or immune signature if you will. Your immune system uses the combinations of many of these antigens to recognize if a cell is a friend or foe. These antigens are also used by the newer myeloma drugs to identify specific cancer cells.
CD45 tends to show up more in the plasma cells during the very earlier stages of multiple myeloma than it does in later stages of the disease. So, assuming you have a diagnosis of multiple myeloma, you would ideally like to see this be positive with a high percentage.
If you want to get into the nuts and bolts of it, see:
http://www.ncbi.nlm.nih.gov/pubmed/15959533
The full text is here:
http://www.readcube.com/articles/10.1038/sj.leu.2403823
But really, along with your overall plasma cell percentage from the BMB, the most important thing you need to pick up on from your FISH and cytogenetic studies are the chromosomal abnormalities (gains, deletions and translocations). These are key in understanding your prognosis and they should be summarized or commented on in your lab results.
Hope this helps...and again, please verify all this with your doc.
CD45 is one of many antigens (a protein) that is found on the surface of cells. Cells have unique combinations of these antigens, which determine a cell's "immunophenotype", or immune signature if you will. Your immune system uses the combinations of many of these antigens to recognize if a cell is a friend or foe. These antigens are also used by the newer myeloma drugs to identify specific cancer cells.
CD45 tends to show up more in the plasma cells during the very earlier stages of multiple myeloma than it does in later stages of the disease. So, assuming you have a diagnosis of multiple myeloma, you would ideally like to see this be positive with a high percentage.
If you want to get into the nuts and bolts of it, see:
http://www.ncbi.nlm.nih.gov/pubmed/15959533
The full text is here:
http://www.readcube.com/articles/10.1038/sj.leu.2403823
But really, along with your overall plasma cell percentage from the BMB, the most important thing you need to pick up on from your FISH and cytogenetic studies are the chromosomal abnormalities (gains, deletions and translocations). These are key in understanding your prognosis and they should be summarized or commented on in your lab results.
Hope this helps...and again, please verify all this with your doc.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Bone marrow biopsy results - CD45 negative 2%?
Thank you multibilly!Are there 2 types .... CD45+ and CD45- ?? That's seems to be tree case in my reading but I don't see any mention of CD45+ on my results. Can/should someone have both? It looks like they stained CD45- and said no reactivity? I know these are hog questions, but knowledge helps ease my mind a bit! 
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Bethc
Re: Bone marrow biopsy results - CD45 negative 2%?
Yeah, all this microbiology nomenclature can be confusing.
When one says a cell is CD45+ or CD45-, they are simply saying whether or not a significant percentage of CD45 is present or not present on the cell's surface, respectively. There is only one type of a CD45 molecule. If you want to get more into this, you can read up on "clusters of differentiation" (which is what the "CD" prefix means on CD45, CD138, etc) here:
http://en.wikipedia.org/wiki/Cluster_of_differentiation
You will also see this kind of "+ and -" nomenclature used when referring to gains and deletions in chromosome abnormalities.
When one says a cell is CD45+ or CD45-, they are simply saying whether or not a significant percentage of CD45 is present or not present on the cell's surface, respectively. There is only one type of a CD45 molecule. If you want to get more into this, you can read up on "clusters of differentiation" (which is what the "CD" prefix means on CD45, CD138, etc) here:
http://en.wikipedia.org/wiki/Cluster_of_differentiation
You will also see this kind of "+ and -" nomenclature used when referring to gains and deletions in chromosome abnormalities.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Bone marrow biopsy results - CD45 negative 2%?
Thanks Multibilly, for all of your helpful posts to the Beacon. You have said you are 'paying it forward', but really, I think it goes beyond that! Do you have a background in science or some branch of health care practise yourself? Anyways, thanks again.
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Bone marrow biopsy results - CD45 negative 2%?
So at top of report -- under bone marrow aspirate -- it states "No significant immunophenotypic abnormalities detected in hemodilute sample. Composed essentially of peripheral blood."
Then one of comments below that speaks to CD45. Since it states "negative and no sig reactivity with markers tested", could this be negative for abnormalities or is it negative expression? (Hope that makes sense).
I'm wondering if CD45 falls under no immunophenotypic abnormalities? In other words, I'm hoping it is normal. But if not I'll deal. My appointment with my onc isn't for 2more weeks so I'm trying to proactively understand some of this stuff.
Additional numbers below:
Myeloid blasts 0%
Lymphocytes 12% B cells 1%
T-cells no sig abnormalities of markers tested
Cd4+ t-cells 6.7% including .5% cd57+ cells
Cd8+ t-cells 2.5% including 1.1% cd57+ cells
Cd4:cd8: 2.8
No-cells: 1%
Plasma cells .1% too few for reliable assessment of colonialists
Neutrophilic cells: 79% intact maturation patterns w increased proportion of mature forms compatible with hemodilution
Monocytes 5% no sig abnormalities
Eosinophils .4% no relative increase
Cd45 negative 2% no sig reactivity with markers tested. Could represent unlisted red blood cells, erythroid precursors
Antibodies performed:
Cd2, cd3, cd4, cd5, cd7, cd8, cd19, kappa, lambda, cd20, cd11b, cd13, cd14, cd33, cd10, cd34, cd45, hla-dr, cd117, cd16, cd38, cd56, cd64, cd57
Even if it's not "ideal" please share your interpretation. Thanks so much!
Then one of comments below that speaks to CD45. Since it states "negative and no sig reactivity with markers tested", could this be negative for abnormalities or is it negative expression? (Hope that makes sense).
I'm wondering if CD45 falls under no immunophenotypic abnormalities? In other words, I'm hoping it is normal. But if not I'll deal. My appointment with my onc isn't for 2more weeks so I'm trying to proactively understand some of this stuff.
Additional numbers below:
Myeloid blasts 0%
Lymphocytes 12% B cells 1%
T-cells no sig abnormalities of markers tested
Cd4+ t-cells 6.7% including .5% cd57+ cells
Cd8+ t-cells 2.5% including 1.1% cd57+ cells
Cd4:cd8: 2.8
No-cells: 1%
Plasma cells .1% too few for reliable assessment of colonialists
Neutrophilic cells: 79% intact maturation patterns w increased proportion of mature forms compatible with hemodilution
Monocytes 5% no sig abnormalities
Eosinophils .4% no relative increase
Cd45 negative 2% no sig reactivity with markers tested. Could represent unlisted red blood cells, erythroid precursors
Antibodies performed:
Cd2, cd3, cd4, cd5, cd7, cd8, cd19, kappa, lambda, cd20, cd11b, cd13, cd14, cd33, cd10, cd34, cd45, hla-dr, cd117, cd16, cd38, cd56, cd64, cd57
Even if it's not "ideal" please share your interpretation. Thanks so much!
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Bethc
Re: Bone marrow biopsy results - CD45 negative 2%?
Beth,
Why are you trying to second guess the pathologist's summary? I would run with:
"No significant immunophenotypic abnormalities detected in hemodilute sample".
...and be happy
Why are you trying to second guess the pathologist's summary? I would run with:
"No significant immunophenotypic abnormalities detected in hemodilute sample".
...and be happy
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Bone marrow biopsy results - CD45 negative 2%?
Haha ... I just saw the CD45 negative and remember reading about it and became immediately alarmed. I wanted to be sure that the "No sig abnorm" applied to that finding as well. Ugh. I'm trying not to read too much, but this entire multiple myeloma experience has me in a nervous frenzy! It's all so surreal. As I'm sure everyone on here can relate.
Thanks for the encouraging reminder Multibilly!
Thanks for the encouraging reminder Multibilly!
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Bethc
Re: Bone marrow biopsy results - CD45 negative 2%?
Hello,
Much good conversation of this topic. To simplify it though -- a patient's CD45 status has no bearing on progression or survival. So, in your report, the percentage of CD45- or CD45+ cells is not important.
You can safely ignore it!
Much good conversation of this topic. To simplify it though -- a patient's CD45 status has no bearing on progression or survival. So, in your report, the percentage of CD45- or CD45+ cells is not important.
You can safely ignore it!
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
Re: Bone marrow biopsy results - CD45 negative 2%?
CD45 is a common leukocyte marker, so can be found on all white blood cells, although as Multibilly said, the amount and isoform will vary between cells.
In the report, the indication of CD45- in 2% population is to say that those cells are not of the white blood cell lineages, and he/she goes on further to say that he/she thinks they are erythroid precursor cells. So, nothing to do with myeloma.
In the report, the indication of CD45- in 2% population is to say that those cells are not of the white blood cell lineages, and he/she goes on further to say that he/she thinks they are erythroid precursor cells. So, nothing to do with myeloma.
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dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
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