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| | HLA-DR |
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| <div style="background-color: #E0EEEE; {{round corners}} padding: 2em 2em; margin-right: 5px;">
| | considered a pan-b lineage marker in leukaemia although the widespread expression limits its value where lineage is ambiguous the expression of HLA-DR may contribute to the assignment of b cell lineage in myeloid leukaemias the absence of HLA-DR can have value in identification of acute promyelocytic leukaemia but molecular typing is required for diagnosis details HLA-DR is typically expressed by macrophages b-cells and dendritic cells. HLA-DR presents antigen to t-helper cells serving to suppress t-helper cell responses and prevent the production of antibodies against self-antigens. HLA-DR is also expressed by early myeloid progenitor cells but expression is lost as they mature to promyelocytes. *myeloid leukaemias generally express HLA-DR is expression is expected to be absent from mature myeloid leukaemias such a apl and erythroid leukaemia *b-lineage leukaemias and lymphomas each generally express HLA-DR although expression is generally lost at the plasma cell stage *t-lineage all is generally HLA-DR negative although rarely mature t cell neoplasms may express HLA-DR |
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| :<span style="color:navy">'''Summary'''</span>
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| :CD33 a useful marker contributing to the diagnosis of AML, but is less specific than myeloperoxidase and may be less sensitive than CD117.
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| :The molecule is expressed by normal maturing myeloid cells, and there is recognised aberrant expression by primitive lymphoid cells (10-20%).
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| </div>
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| <span style="color:navy">'''Normal expression and function'''</span>
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| CD33 a transmembrane receptor that is thought to function as an inhibitory protein supressing signals of the innate immune system. It is strongly expressed on multi-lineage hematopoietic progenitors and also on myelomonocytic precursors (although generally less strongly than CD13). Expression is absent from the more primitive pluripotent hematopoietic stem cells and CD33 is down-regulated on mature granulocytes, human mast cells, and blood basophils.
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| <span style="color:navy">'''Diagnostic role'''</span>
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| *Overall around 80-90% of AML cases express CD33; although the marker tends not to be expressed the least mmature forms, as well as those with erythroid or megakaryocytic differentiation. High CD33 expression may correlate with ''NPM1'' mutation
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| *Approximately 10% of B or T lymphoblastic leukaemias and lymphomas may aberrantly express CD33 as well as up to 25% of myeloma cases
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| *CD33 not expressed by mature cells of erythroid, platelet, B-cells T-cells or NK-cell lineage
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| *CD33 is expressed throughout myeloid maturation and is found on mature myeloid cells, though less strongly on cells of monocytic lineage
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| <span style="color:navy">'''Other relevant information:'''</span>
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| CD33 has received particular attention for its role as the molecular target of antibody-based treatment strategies in the therapy of AML.
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| <span style="color:navy">'''''SUMMARY TABLES'''''</span>
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| <span style="font-size:90%">'''Note''' The colour and % refer to the proportion of cases expressing the marker. Additional comments on strength, or site of expression (if relevant) are given below the table. For full details of key click [[Key to marker expression table|here]]. For further information about a particular disease state click <<span style="color:blue>'''I'''</span>> adjacent to the condition name</span>
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| {| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
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| !colspan="8"|<span style="font-size:100%">'''Expression in primitive cell types'''</font>
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| ! AML !! CMML !! B ALL !! Burkitt || T ALL !! ETP ALL <'''[[ETP ALL|I]]'''> !! MPAL <'''[[MPAL|I]]'''> || Hgns <'''[[Hgns|I]]'''>
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| |-
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| |style="width: 12.5%; background: #004466; color:white"|80-100%*
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| |style="width: 12.5%; background: #004466; color:white"|80-100%
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| |style="width: 12.5%; background: #00b8e6; color:black"|20-40%**
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| |style="width: 12.5%; background: #66e0ff; color:black"|5-20%
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| |style="width: 12.5%; background: #66e0ff; color:black"|5-20%
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| |style="width: 12.5%; background: #00b8e6; color:black"|20-40%**
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| |style="width: 12.5%; background: #00b8e6; color:black"|20-40%**
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| |style="width: 12.5%; background:#004466; color:white"|80-100%***
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| |-
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| |}
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| <span style="font-size:90%">'''Notes:''' ''*'' most cases of AML express this marker although it can be absent (see notes above) ''**'' CD33 is commonly expressed in ALL (particularly B-ALL), but in the correct context can also contribute to detection of MPAL or ETP-ALL, ''***'' Haematogones frequently express CD33 </span>
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| {| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
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| !colspan="8"|'''Expression in mature B cell neoplasms'''
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| |-
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| ! CLL !! MCL !!FL!! MZL !! HCL !! DLBCL || LPL !! PCL
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| |-
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| |style="width: 12.5%; background: #E6FAFF; color:black"|<5%
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| |style="width: 12.5%; background: #E6FAFF; color:black"|<5%
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| |style="width: 12.5%; background: #E6FAFF; color:black"|<5%
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| |style="width: 12.5%; background: #E6FAFF; color:black"|<5%
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| |style="width: 12.5%; background: #E6FAFF; color:black"|<5%
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| |style="width: 12.5%; background: #E6FAFF; color:black"|<5%
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| |style="width: 12.5%; background: #E6FAFF; color:black"|<5%
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| |style="width: 12.5%; background: #66e0ff; color:black"|5-20%
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| |-
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| |}
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| <span style="font-size:90%">'''Notes:''' CD33 is occasionally expressed in mature lymphoid malignancies more frequently in b cell types</span>
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| {| class=wikitable style="text-align: center; font-size:80%; width: 62.4%; height 40px;"
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| !colspan="7"|'''CD13 expression: mature T cell neoplasms'''
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| ! ATLL !! CTCL Sezary !! T-PLL !! T-LGL !! NK-LGL
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| |-
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| |style= "width: 20%; background: #FFE4E1; color:black"|limited
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| |style="width: 20%; background: #FFE4E1; color:black"|limited
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| |style="width: 20%; background: #FFE4E1; color:black"|limited
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| |style= "width: 20%; background: #FFE4E1; color:black"|limited
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| |style="width: 20%; background: #FFE4E1; color:black"|limited
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| |-
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| |}
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| <span style="font-size:90%">'''Notes:''' There is limited published evidence, but reports suggest expression of CD33 is uncommon in mature T cell malignancy</span>
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| ----
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