I’ll give you a laypersons shot of an answer, most of it’s over my head.
Cll is a bcell cancer. Bcells are a type of lymphocyte, lymphocytes are a type of white blood cell.
To determine if we have Cll, doctors look at a test called flow cytometry that looks at molecules on our cell surfaces. Our bcells have certain proteins on their surface. These proteins are identified by a numbering system for clusters of differentiation (CD).
Typical Cll cases show expressions of CD 5, CD 19 and CD 23, along with other markers. Other bcell cancers are identified by CD groups as well. When a pattern of CD expression is close to Cll, but doesn’t fit it exactly, it can be called atypical Cll. Atypical Cll often involves expression of CD 200, which is notable in your labs.
Sometimes atypical Cll can be more aggressive than typical Cll. Your atypical Cll is accompanied by mutated IGHV and 13q deleted, both very favorable markers. I would think your version of atypical Cll might not be as aggressive as other versions thanks to your favorable FISH and IGHV findings.
Of course your doctor would be the best person to ask what prognostic implications, if any, there are for you having atypical Cll. I would think the treatment for typical and atypical Cll would be the same. I would think being 13q and having mutated IGHV are favorable markers, both for typical and atypical Cll.
Expression means the marker was detected. Whether a marker is noted as being positive or negative depends on whether the marker is above or below a threshold. Above or 'bright', is positive, below, or 'dim', is negative. The threshold varies by marker. Sometimes there isn't an agreed threshold, there could be more than one.
Patterns from all the markers are used to identify different blood cancers.
"Other cases may co-express CD19, CD5, bright CD20, and lack CD23 ("atypical CLL")" --
this was a statement I copied from a description of MBL---and is an example of an atypical CLL description. It has to do with the profile findings of Flow Cytometry Testing.
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