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


CD38 helps mobilise intracellular calcium to activate a wide array of cell functions. In haematological cell types CD38 it is widely expressed by lymphoid cells )B, T and NK) as well as myeloid precursor cells and mature myeloid cells. It has particular diagnostic importance  for lymphocytes where CD38 expression is acquired as stem cells commit to B-cell lineage, then is lost as mature B cells emerge from bone marrow before being re-acquired at the time of plasma cell differentiation.
:CD38 helps mobilise intracellular calcium to activate a wide array of cell functions. In haematological cell types CD38 it is widely expressed by lymphoid cells B, T and NK) as well as myeloid precursor cells and mature myeloid cells.  
:CD38 has particular diagnostic importance  for lymphocytes where CD38 expression is acquired as stem cells commit to B-cell lineage, then is lost as mature B cells emerge from bone marrow before being re-acquired at the time of plasma cell differentiation.




<span style="color:navy">'''What is its diagnostic role?'''</span>  
</div>


*The wide expression of CD38 limits its diagnostic value except in very specific circumstances
 
*The major use is to combine CD38 with CD138 where co-expression identifies normal or neoplastic plasma cells
 
 
<span style="color:navy">'''Normal expression and function'''</span>
 
The wide expression of CD38 limits its diagnostic value except in very specific circumstances:
*The co-expression of CD38 with CD138 can identify normal or neoplastic plasma cells
*Expression of CD38 in chronic lymphocytic leukaemia (>20% of cells) may associated with poorer outcome
*Expression of CD38 in chronic lymphocytic leukaemia (>20% of cells) may associated with poorer outcome




<span style="color:navy">'''Other relevant information:'''</span> CD38 is a therapeutic target, daratumumab is a monoclonal antibody which binds to CD38 and is used in the treatment of myeloma.
 
<span style="color:navy">'''Other relevant information:'''</span>  
 
CD38 is a therapeutic target, daratumumab is a monoclonal antibody which binds to CD38 and is used in the treatment of myeloma.




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<span style="color:navy">'''''SUMMARY TABLES'''''</span>
{| class=wikitable style="text-align: center; width: 800px;"


{| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
|-
|-
!colspan="8"|Expression of CD38 by primitive lymphoid cells: ALL and haematogones
!colspan="8"|'''Expression in primitive cell types'''</font>
|-  
|- <span style="font-size:70%">
! pro-B ALL !! early pre-B ALL !!pre-B ALL!! B-ALL !!pro-T ALL !!mature-T ALL !!AML !!Haematogones
!AML!!CMML !!B ALL !!BL ||T ALL !!ETP ALL !!MPAL ||Hgn</span>
|-
|-<span style="font-size:70%">
|style= "width: 100px; height: 20px; background: #006699; color:white"|
|style="width: 12.5%; background: #00b8e6; color:black"|2-20%*
|style="width: 100px; background: #006699; color:white"|
|style="width: 12.5%; background: #006699; color:white"|40-80%
|style="width: 100px; background: #006699; color:white"|
|style="width: 12.5%; background: #006699; color:white"|40-80%
|style="width: 100px; background: #006699; color:white"|
|style="width: 12.5%; background: #006699; color:white"|40-80%
|style="width: 100px; background: #006699; color:black"|
|style="width: 12.5%; background: #006699; color:white"|40-80%
|style="width: 100px; background: #006699; color:black"|
|style="width: 12.5%; background: #006699; color:white"|40-80%
|style="width: 100px; background: #00b8e6; color:white"|*
|style="width: 12.5%; background: #006699; color:white"|40-80%
|style="width: 100px; background: #004466; color:white"|stg
|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:''' ''*'' expression correlates with subtype, particularly APML. Expression by haematogones is very high. </span>


{| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
|-
|-
!colspan="8"|Expression of CD38 by mature B cells: B-lymphoproliferative disorders
!colspan="8"|'''Expression in mature B cell neoplasms'''
|-  
|- <span style="font-size:70%">
! CLL !! MCL !!FL!! HCL !!HCv !!MZL!!LPL!!PCL
! CLL !! MCL !!FL!! MZL !! HCL !! DLBCL || LPL !! PCL
|-
|-<span style="font-size:70%">
|style= "width: 100px; background: #00b8e6; color:black"|*
|style="width: 12.5%; background: #00b8e6; color:black"|2-20%*
|style="width: 100px; background: #004466; color:white"|
|style="width: 12.5%; background: #004466; color:white"|80-100%
|style="width: 100px; background: #004466; color:white"|**
|style="width: 12.5%; background: #004466; color:white"|80-100%
|style= "width: 100px; background: #00b8e6; color:white"|
|style="width: 12.5%; background: #004466; color:white"|80-100%
|style= "width: 100px; background: #00b8e6; color:white"|
|style="width: 12.5%; background: #00b8e6; color:black"|2-20%
|style="width: 100px; background: #004466; color:white"|
|style="width: 12.5%; background: #004466; color:white"|80-100%*
|style="width: 100px; background: #006699; color:white"|
|style="width: 12.5%; background: #006699; color:white"|40-80%
|style="width: 100px; background: #004466; color:white"|stg/mod
|style="width: 12.5%; background: #004466; color:white"|80-100%**
|-
|-
|}
|}
<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>
<span style="font-size:90%">'''Notes:''' Expression level in CLL and DLBCL may have prognostic value, plasma cells express the marker fairly consistently although the levels can vary. </span>
 


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<span style="font-size:80%">'''''1. Colour key:''''' ''- the likelihood of any individual case expressing this marker, indicated by colour:''
{| class=wikitable style="text-align: center; font-size:80%; width: 62.4%; height 40px;"
</span>
|-
{| class=wikitable style="text-align: center; font-size:80%; width: 600px; height: 20px;
!colspan="7"|'''Expression in mature T cell neoplasms'''
|-
! ATLL !! CTCL/Sezary !! T-PLL !! T-LGL !! NK-LGL
|-
|-
|style= "background: #E6FAFF; |Rare (<5%)
|style="width: 12.5%; background: #004466; color:white"|80-100%
|style="background: #66e0ff;"|Possible (5-20%)
|style="width: 12.5%; background: #004466; color:white"|80-100%
|style="background: #00b8e6;"|Likely (20-40%)
|style="width: 12.5%; background: #004466; color:white"|80-100%
|style="background: #006699; color:white"|Frequent (40-80%)
|style="width: 12.5%; background: #004466; color:white"|80-100%
|style="background: #004466; color:white"|Expected (80-100%)
|style="width: 12.5%; background: #004466; color:white"|80-100%
|-
|-
|}
|}


<span style="font-size:80%">
'''''2. Text key''''': - ''where expression level is characteristic of a disorder this is indicated by text:''
</span>


<span style="font-size:80%">
----
'''abs''' = absent expression, '''wk''' = weak expression, '''mod''' = moderate expression, '''stg''' = strong expression, '''sub''' = expression may be on a sub-population of cells''
</span>

Latest revision as of 21:43, 4 July 2023


Summary
CD38 helps mobilise intracellular calcium to activate a wide array of cell functions. In haematological cell types CD38 it is widely expressed by lymphoid cells B, T and NK) as well as myeloid precursor cells and mature myeloid cells.
CD38 has particular diagnostic importance for lymphocytes where CD38 expression is acquired as stem cells commit to B-cell lineage, then is lost as mature B cells emerge from bone marrow before being re-acquired at the time of plasma cell differentiation.




Normal expression and function

The wide expression of CD38 limits its diagnostic value except in very specific circumstances:

  • The co-expression of CD38 with CD138 can identify normal or neoplastic plasma cells
  • Expression of CD38 in chronic lymphocytic leukaemia (>20% of cells) may associated with poorer outcome


Other relevant information:

CD38 is a therapeutic target, daratumumab is a monoclonal antibody which binds to CD38 and is used in the treatment of myeloma.



Expression in primitive cell types
AML CMML B ALL BL T ALL ETP ALL MPAL Hgn
2-20%* 40-80% 40-80% 40-80% 40-80% 40-80% 40-80% 80-100%*

Notes: * expression correlates with subtype, particularly APML. Expression by haematogones is very high.


Expression in mature B cell neoplasms
CLL MCL FL MZL HCL DLBCL LPL PCL
2-20%* 80-100% 80-100% 80-100% 2-20% 80-100%* 40-80% 80-100%**

Notes: Expression level in CLL and DLBCL may have prognostic value, plasma cells express the marker fairly consistently although the levels can vary.


Expression in mature T cell neoplasms
ATLL CTCL/Sezary T-PLL T-LGL NK-LGL
80-100% 80-100% 80-100% 80-100% 80-100%


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