Actions

CD13: Difference between revisions

From haematologyetc.co.uk

No edit summary
No edit summary
 
(149 intermediate revisions by the same user not shown)
Line 3: Line 3:




:<span style="color:navy">'''Summary'''</span>


:A useful marker of myeloid lineage although expression depends significantly on stage and type of maturation (see Diagnostic Role). CD13 has recognised aberrant expression in some cases of ALL (particularly B-lineage)
</div>
</div>


Line 10: Line 14:
<span style="color:navy">'''Normal expression and function'''</span>
<span style="color:navy">'''Normal expression and function'''</span>


CD13 is an enzyme which cleaves eutral amino acids from the N terminus of small peptides. The function of CD13 appears to vary with the tissue and the precise function in myeloid cells is unclear.  The pattern of expression that is similar to other pan-myeloid markers (CD117 and CD33), but with levels generally increasing during maturation (contrasting with CD33 whose expression decreases). Maturation of myeloid cells may be partly identified through the relative CD33/13 expression.
CD13 is a cell surface enzyme whose function varies between tissues; its precise function in myeloid cells is unclear.  The pattern of expression is similar to other pan-myeloid markers (CD117 and CD33), but with levels generally increasing during maturation (contrasting with CD117 and CD33 whose expression decreases). Maturation of normal myeloid cells may therefore be partly idicated through the relative CD33/13 expression.




Line 16: Line 20:
<span style="color:navy">'''Diagnostic role'''</span>  
<span style="color:navy">'''Diagnostic role'''</span>  


*Together with other markers (CD117, CD33 and MPO) CD13 identifies myeloid lineage, particularly acute myeloid leukaemia. CD13 is also found on myelomonocytic and monocytic leukaemias.
*Together with other markers (CD117, CD33 and MPO), CD13 can be used to identify myeloid lineage in acute myeloid leukaemia.  
 
*Expression is often absent on more primitive AML, erythroid or megakaryoblastic AML


*Aberrant expression by ALL occurs in around 30% of patients (at the 20% threshold)
*CD13 is also expressed by myelomonocytic and monocytic leukaemia cells where a high ratio of CD13/CD33 may help suggest monocytic lineage


*Overall high sensitivity, but may be less specific than CD117 or MPO.
*Expression of CD34 is not required to diagnose AML and is not fully specific - CD13 is often absent on more primitive AML cases as well as on those with erythroid or megakaryoblastic differentiation; while aberrant expression in ALL is recognised to occur in around 30% of patients.
CD13 is often regarded as less specific for myeloid lineage than either CD117 or MPO.
   
   


<span style="color:navy">'''Other relevant information:'''</span>  
<span style="color:navy">'''Other relevant information:'''</span>  


 
Expression is not restricted to myeloid cells, and CD13 is particularly expressed on small intestinal and renal tubular epithelial cells and synaptic membranes from the CNS.
Outside the haematopoietic system CD13 is particularly expressed on small intestinal and renal tubular epithelial cells and synaptic membranes from the CNS.




----
----
----


<span style="color:navy">'''''SUMMARY TABLES'''''</span>
<span style="color:navy">'''''SUMMARY TABLES'''''</span>


{| class=wikitable style="text-align: center;"
 
|-
{| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
!colspan="8"|Expression of CD13 by cells with early differentiation: ALL and haematogones
|-
! pro-B ALL !! early pre-B ALL !!pre-B ALL!! B-ALL !!pro-T ALL !!mat T-ALL !!AML !!Hgns
|-
|-
|style= "width: 40px; height: 20px; background: #006699; color:white"|poss
!colspan="8"|'''Expression in primitive cell types'''</font>
|style="width: 60px; background: #006699; color:white"|poss
|- <span style="font-size:70%">
|style="width: 60px; background: #006699; color:white"|poss
!AML!!CMML !!B ALL !!BL ||T ALL !!ETP ALL !!MPAL ||Hgn</span>
|style="width: 60px; background: #006699; color:white"|rare
|-<span style="font-size:70%">
|style="width: 60px; background: #006699; color:black"|rare
|style="width: 12.5%; background: #004466; color:white"|80-100%*
|style="width: 60px; background: #006699; color:black"|rare
|style="width: 12.5%; background: #004466; color:white"|80-100%
|style="width: 60px; background: #00b8e6; color:white"|strg
|style="width: 12.5%; background: #00b8e6; color:black"|20-40%**
|style="width: 60px; background: #004466; color:white"|freq
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 12.5%; background: #00b8e6; color:black"|20-40%**
|style="width: 12.5%; background: #00b8e6; color:black"|20-40%**
|style="width: 12.5%; background:#004466; color:white"|80-100%***
|-
|-
|}
|}
<span style="font-size:80%">''* low expression correlates with subtype e.g. APML''</span>


{| class=wikitable style="text-align: center; width: 800px; height 20px;"


|-
<span style="font-size:90%">'''Notes:''' The main application is in AML. Aberrant expression is seen particularly in B-lineage, although it may be less likely in Burkitt lymphoma. CD13 is not generally expressed in T-ALL. CD13 expression can indicate MPAL or ETP-ALL if other markers suggest this.
!colspan="8"|Expression of CD38 by mature B cells: B-lymphoproliferative disorders
|-
! CLL !! MCL !!FL!! HCL !!HCv !!MZL!!LPL!!PCL
|-
|style= "width: 100px; background: #00b8e6; color:black"|rare
|style="width: 100px; background: #004466; color:white"|rare
|style="width: 100px; background: #004466; color:white"|rare
|style= "width: 100px; background: #00b8e6; color:white"|rare
|style= "width: 100px; background: #00b8e6; color:white"|rare
|style="width: 100px; background: #004466; color:white"|rare
|style="width: 100px; background: #006699; color:white"|rare
|style="width: 100px; background: #004466; color:white"|rare
|-
|}
<span style="font-size:80%">''*May indicate adverse prognostic when present on more than 20% of cells''</span>


<span style="font-size:80%">''**May be weak''</span>


----
{| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
 
<span style="font-size:80%">'''''1. Colour key:''''' ''- the likelihood of any individual case expressing this marker, indicated by colour:''
</span>
{| class=wikitable style="text-align: center; font-size:80%; width: 600px; height: 20px;
|-
|-
|style= "background: #E6FAFF; |Rare (<5%)
!colspan="8"|'''Expression in mature B cell neoplasms'''
|style="background: #66e0ff;"|Possible (5-20%)
|- <span style="font-size:70%">
|style="background: #00b8e6;"|Likely (20-40%)
! CLL !! MCL !!FL!! MZL !! HCL !! DLBCL || LPL !! PCL
|style="background: #006699; color:white"|Frequent (40-80%)
|-<span style="font-size:70%">
|style="background: #004466; color:white"|Expected (80-100%)
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #00b8e6; color:black"|20-40%
|style="width: 12.5%; background: #00b8e6; color:black"|20-40%
|-
|-
|}
|}


<span style="font-size:80%">
<span style="font-size:90%">'''Notes:''' overall expression is uncommon in mature B-lymphoproliferative disorders, but may occur at plasma cell differentiation</span>
'''''2. Text key''''': - ''where expression level is characteristic of a disorder this is indicated by text:''
</span>  


<span style="font-size:80%">
<span style="font-size:90%"> Additional note [[PLL]] and [[vHCL]] are no longer included, click on the name for further information</span>
'''abs''' = absent expression, '''wk''' = weak expression, '''mod''' = moderate expression, '''stg''' = strong expression, '''sub''' = expression may be on a sub-population of cells''
</span>


<span style="color:navy">'''''SUMMARY TABLES'''''</span>
Expression by acute leukaemias and by haematogones
<gallery widths="40px" heights="40px" >
File:Poss.png|''Pro-B ALL''|link=Flow cytometry key
File:Poss.png|''Early pre-B ALL''|link=Flow cytometry key
File:Poss.png|''Pre-B ALL''|link=Flow cytometry key
File:Rare.png|''B ALL''|link=Flow cytometry key
File:Rare.png|''Pro-T ALL''|link=Flow cytometry key
File:Rare.png|''Mature-T ALL''|link=Flow cytometry key
File:Hi.png|''AML''|link=Flow cytometry key
File:Freq.png|''Haemato-gones''|link=Flow cytometry key
</gallery>
<span style="font-size:90%">'''Notes'''
''In ALL the expression of CD13 is more likely in B-ALL but is also seen in T-ALL''
''In AML CD13 is expressed in around 80% of cases''
''In haematogones expression of CD13 is very frequent''
</span>
Expression by B-lymphoproliferative disorders
<gallery widths="40px" heights="40px" >
File:Rare.png|frame|''CLL''|link=Flow cytometry key
File:Rare.png|''PLL''|link=Flow cytometry key
File:Rare.png|''MCL''|link=Flow cytometry key
File:Rare.png|''FL'|link=Flow cytometry key
File:Rare.png|''HCL''|link=Flow cytometry key
File:Rare.png|''HCLv''|link=Flow cytometry key
File:Rare.png|''MZL''|link=Flow cytometry key
File:Rare.png|''LPL''|link=Flow cytometry key
File:Rare.png|''PCs''|link=Flow cytometry key
</gallery>
----
'''KEY'''
<div class="toccolours mw-collapsible mw-collapsed" style="font-size 80%; overflow:auto;">
The indicated expression frequency, indicates the approximate frequency of occurrence in each particular disease type.
[[File:Rare.png|30px|link=]]
rare (<5%)
[[File:Poss.png|30px|link=]]
possible (5-20%)
[[File:Mod.png|30px|link=]]
likely (20-40%)
[[File:Freq.png|30px|link=]]
frequent (40-80%)
[[File:Hi.png|30px|link=]]
expected (>80%)
Where expression level is unusual or characteristic of a disorder this is indicated by text:
</div>




{| class=wikitable style="text-align: center; font-size:80%; width: 62.4%; height 40px;"
|-
!colspan="7"|'''CD13 expression: mature T cell neoplasms'''
|-
! ATLL !! CTCL Sezary !! T-PLL !! T-LGL !! NK-LGL
|-
|style= "width: 20%; background: #FFE4E1; color:black"|limited
|style="width: 20%; background: #FFE4E1; color:black"|limited
|style="width: 20%; background: #FFE4E1; color:black"|limited
|style= "width: 20%; background: #FFE4E1; color:black"|limited
|style="width: 20%; background: #FFE4E1; color:black"|limited
|-
|}


<span style="font-size:90%">'''Notes:''' There is limited published evidence, but reports suggest expression of CD13 is uncommon in mature T cell malignancy</span>


----
----

Latest revision as of 21:37, 4 July 2023


Summary
A useful marker of myeloid lineage although expression depends significantly on stage and type of maturation (see Diagnostic Role). CD13 has recognised aberrant expression in some cases of ALL (particularly B-lineage)



Normal expression and function

CD13 is a cell surface enzyme whose function varies between tissues; its precise function in myeloid cells is unclear. The pattern of expression is similar to other pan-myeloid markers (CD117 and CD33), but with levels generally increasing during maturation (contrasting with CD117 and CD33 whose expression decreases). Maturation of normal myeloid cells may therefore be partly idicated through the relative CD33/13 expression.


Diagnostic role

  • Together with other markers (CD117, CD33 and MPO), CD13 can be used to identify myeloid lineage in acute myeloid leukaemia.
  • CD13 is also expressed by myelomonocytic and monocytic leukaemia cells where a high ratio of CD13/CD33 may help suggest monocytic lineage
  • Expression of CD34 is not required to diagnose AML and is not fully specific - CD13 is often absent on more primitive AML cases as well as on those with erythroid or megakaryoblastic differentiation; while aberrant expression in ALL is recognised to occur in around 30% of patients.

CD13 is often regarded as less specific for myeloid lineage than either CD117 or MPO.


Other relevant information:

Expression is not restricted to myeloid cells, and CD13 is particularly expressed on small intestinal and renal tubular epithelial cells and synaptic membranes from the CNS.


SUMMARY TABLES


Expression in primitive cell types
AML CMML B ALL BL T ALL ETP ALL MPAL Hgn
80-100%* 80-100% 20-40%** 5-20% 5-20% 20-40%** 20-40%** 80-100%***


Notes: The main application is in AML. Aberrant expression is seen particularly in B-lineage, although it may be less likely in Burkitt lymphoma. CD13 is not generally expressed in T-ALL. CD13 expression can indicate MPAL or ETP-ALL if other markers suggest this.


Expression in mature B cell neoplasms
CLL MCL FL MZL HCL DLBCL LPL PCL
<5% <5% <5% <5% <5% <5% 20-40% 20-40%

Notes: overall expression is uncommon in mature B-lymphoproliferative disorders, but may occur at plasma cell differentiation

Additional note PLL and vHCL are no longer included, click on the name for further information


CD13 expression: mature T cell neoplasms
ATLL CTCL Sezary T-PLL T-LGL NK-LGL
limited limited limited limited limited

Notes: There is limited published evidence, but reports suggest expression of CD13 is uncommon in mature T cell malignancy

Retrieved from ‘https://haematologyetc.co.uk/index.php?title=CD13&oldid=2226’