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


:CD33 a useful marker contributing to the diagnosis of AML, but is less specific than myeloperoxidase and may be less sensitive than CD117.  
:CD138 is a marker used to identify normal or malignant plasma cells with a high level of specificity, but does not discriminate normal from abnormal plasma cells and in some cases expression in myeloma may be low compared with normal plasma cells so sensitivity can be an issue. Abberancy of expression is low, but expression may be seen in lymphoplamacytic or marginal zone lymphomas (only on those cells that have plasma cell differentiation)
: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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<span style="color:navy">'''Normal expression and function'''</span>
<span style="color:navy">'''Normal expression and function'''</span>


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.
CD138 is a membrane protein that supports cell adhesion or binds cytokines and chemokines. In the hematopoietic system expression of CD138 is acquired by B lymphocytes as they develop into plasma cells.




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


*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
*Most often CD138 used in conjunction with CD38 to identify plasma cells in the diagnosis or monitoring of myeloma
*Approximately 10% of B or T lymphoblastic leukaemias and lymphomas may aberrantly express CD33 as well as up to 25% of myeloma cases
*There is very little aberrant expression, but neoplastic plasma cells may in some cases have weak, variable, or occasionally undetectable expression
*CD33  not expressed by mature cells of erythroid, platelet, B-cells T-cells or NK-cell lineage
*Expression is also seen cells that have plasmacytic differentiation in lymphoplasmacytoid lymphoma or marginal zone lymphoma  
*CD33 is expressed throughout myeloid maturation and is found on mature myeloid cells, though less strongly on cells of monocytic lineage  






<span style="color:navy">'''Other relevant information:'''</span>  
<span style="color:navy">'''Other useful information'''</span>  
 
CD33 has received particular attention for its role as the molecular target of antibody-based treatment strategies in the therapy of AML.


Outside of haematopoiesis CD138 is expressed by squamous epithelium.


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




<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>
{| class=wikitable style="text-align: center; font-size:80%; width: 87.5%; height 20px;"
 
 
{| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
|-
|-
!colspan="8"|<span style="font-size:100%">'''Expression in primitive cell types'''</font>
!colspan="7"|<span style="font-size:100%">'''Expression: primitive cell types''' ''Click (i) on table for additional information'' </span></font>
|-  
|-  
! AML !! CMML !! B ALL !! Burkitt || T ALL !! ETP ALL <'''[[ETP ALL|I]]'''> !! MPAL <'''[[MPAL|I]]'''> || Hgns <'''[[Hgns|I]]'''>
! AML !! B ALL !! Burkitt || T ALL !! ETP ALL ('''[[Early T Precursor ALL (ETP-ALL)|i]]''') !! MPAL ('''[[Mixed Phenotype Acute Leukaemia (MPAL)|i]]) || H.gones ('''[[Haematogones|i]]''')
|-
|-
|style="width: 12.5%; background: #004466; color:white"|80-100%*
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #004466; color:white"|80-100%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #00b8e6; color:black"|20-40%**
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #00b8e6; color:black"|20-40%**
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background: #00b8e6; color:black"|20-40%**
|style="width: 12.5%; background: #E6FAFF; color:black"|<5%
|style="width: 12.5%; background:#004466; color:white"|80-100%***
|-
|-
|}
|}


<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>




{| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
{| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
|-
|-
!colspan="8"|'''Expression in mature B cell neoplasms'''
!colspan="8"|'''Expression: mature B cell neoplasms'''
|-  
|-  
! CLL !! MCL !!FL!! MZL !! HCL !! DLBCL || LPL !! PCL
! CLL !! MCL !!FL!! MZL !! HCL !! DLBCL || LPL !! PCL
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|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: #66e0ff; color:black"|5-20%
|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: #66e0ff; color:black"|5-20%
|style="width: 12.5%; background: #66e0ff; color:black"|5-20%
|style="width: 14.25%; background: #006699; color:white"|40-80%
|style="width: 12.5%; background: #004466; color:white"|80-100%
|-
|-
|}
|}


<span style="font-size:90%">'''Notes:''' CD33 is occasionally expressed in mature lymphoid malignancies more frequently in b cell types</span>
<span style="font-size:90%">'''Notes:''' expression is usual in myeloma, and will occur on cells with plasma cell differentiation in LPL or MZL</span>
 




{| class=wikitable style="text-align: center; font-size:80%; width: 62.4%; height 40px;"
{| class=wikitable style="text-align: center; font-size:80%; width: 62.4%; height 40px;"
|-
|-
!colspan="7"|'''CD13 expression: mature T cell neoplasms'''
!colspan="7"|'''Expression: mature T cell neoplasms'''
|-  
|-  
! ATLL !! CTCL Sezary !! T-PLL !! T-LGL !! NK-LGL
! ATLL !! CTCL Sezary !! T-PLL !! T-LGL !! NK-LGL
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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>
<span style="font-size:90%">'''Notes:''' limited reports are consistent with expression being very uncommon in T-lymphoproliferative disorders</span>
 
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Latest revision as of 20:53, 13 June 2023


Summary
CD138 is a marker used to identify normal or malignant plasma cells with a high level of specificity, but does not discriminate normal from abnormal plasma cells and in some cases expression in myeloma may be low compared with normal plasma cells so sensitivity can be an issue. Abberancy of expression is low, but expression may be seen in lymphoplamacytic or marginal zone lymphomas (only on those cells that have plasma cell differentiation)



Normal expression and function

CD138 is a membrane protein that supports cell adhesion or binds cytokines and chemokines. In the hematopoietic system expression of CD138 is acquired by B lymphocytes as they develop into plasma cells.



Diagnostic role

  • Most often CD138 used in conjunction with CD38 to identify plasma cells in the diagnosis or monitoring of myeloma
  • There is very little aberrant expression, but neoplastic plasma cells may in some cases have weak, variable, or occasionally undetectable expression
  • Expression is also seen cells that have plasmacytic differentiation in lymphoplasmacytoid lymphoma or marginal zone lymphoma


Other useful information

Outside of haematopoiesis CD138 is expressed by squamous epithelium.


SUMMARY TABLES


Expression: primitive cell types Click (i) on table for additional information
AML B ALL Burkitt T ALL ETP ALL (i) MPAL (i) H.gones (i)
<5% <5% <5% <5% <5% <5% <5%


Expression: mature B cell neoplasms
CLL MCL FL MZL HCL DLBCL LPL PCL
<5% <5% <5% 5-20% <5% 5-20% 40-80% 80-100%

Notes: expression is usual in myeloma, and will occur on cells with plasma cell differentiation in LPL or MZL


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

Notes: limited reports are consistent with expression being very uncommon in T-lymphoproliferative disorders