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mpo (myeloperoxidase)


MPO expression is strongly associated with granulocytic maturation. In acute leukaemia MPO has high specificity for the diagnosis of AML, although expression may be observed on more primitive AML, or where maturation is non-granulocytic e.g. erythroid or megakaryocyte lineages and on some monocytic cases. Expression is not observed in typical ALL, if MPO is detected in ALL then this supports the diagnosis of mixed-phenotype acute leukaemia (MPAL). 
<div style="background-color: #E0EEEE; {{round corners}} padding: 2em 2em;  margin-right: 5px;">


normal function and expression 


Myeloperoxidase is a lysosomal enzyme used by neutrophils to kill pathogens. It is present in neutrophils and eosinophils at all stages of maturation, and in developing basophils. MPO may be expressed at low intensity in monocytes but erythroid precursors and lymphocytes are MPO-negative. 
:<span style="color:navy">'''Summary'''</span>


: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)


what is its diagnostic role 
</div>


*MPO is expressed in around 60% of AML cases - generally those with granulocytic maturation and is weakly expressed by promonocytes
*In otherwise typical ALL a small number of MPO-expressing cells may be seen although precise criteria vary (most often <5%)
*In cases of mixed phenotype acute leukaemia (MPAL), expression of mpo can alone be used to establish myeloid differentiation 


other relevant information 
Technically enzymatic measures of MPO (cytochemical or sudan black B staining) are probably the least sensitive detection methods. Flow cytometric detection of MPO has lower sensitivy than immunohistochemical detection on trephine; this may be because immunocytochemistry detects expression of a precursor enzyme form of MPO as well as thefunctional form. For this reason, if there is doubt about MPO expression then MPO staining of trephine biopsies can be useful.


summary tables 
<span style="color:navy">'''Normal expression and function'''</span>


expression by acute leukaemias and by haematogones
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.
rare pro-ball 
rare early pre-ball 
rare pre-ball 
rare ball 
rare pro-tall 
rare mature-tall 
mod aml * 
rare haemato-gones 
*  *inamlmpoishighly specific fordiagnosis butisnotdetected inallcases  2.  


expression byb-lymphoproliferative disorders 
 
rare cll*   
 
rare pll  
 
rare mcl 
<span style="color:navy">'''Diagnostic role'''</span>
rare fl
 
rare hcl 
*Most often CD138 used in conjunction with CD38 to identify plasma cells in the diagnosis or monitoring of myeloma
rare hclv 
*There is very little aberrant expression, but neoplastic plasma cells may in some cases have weak, variable, or occasionally undetectable expression  
rare mzl 
*Expression is also seen cells that have plasmacytic differentiation in lymphoplasmacytoid lymphoma or marginal zone lymphoma  
rare lpl 
 
rare pcs
 
 
<span style="color:navy">'''Other useful information'''</span>
 
Outside of haematopoiesis CD138 is expressed by squamous epithelium.
 
----
 
<span style="color:navy">'''''SUMMARY TABLES'''''</span>
 
 
{| class=wikitable style="text-align: center; font-size:80%; width: 87.5%; height 20px;"
|-
!colspan="7"|<span style="font-size:100%">'''Expression: primitive cell types''' ''Click (i) on table for additional information'' </span></font>
|-
! 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: #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: #E6FAFF; color:black"|<5%
|-
|}
 
 
 
{| class=wikitable style="text-align: center; font-size:80%; width: 100%; height 20px;"
|-
!colspan="8"|'''Expression: mature B cell neoplasms'''
|-
! CLL !! MCL !!FL!! MZL !! HCL !! DLBCL || LPL !! PCL
|-
|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: #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:''' 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;"
|-
!colspan="7"|'''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:''' limited reports are consistent with expression being very uncommon in T-lymphoproliferative disorders</span>
----

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