Building a new score system for the diagnosis and differential diagnosis of typical CLL/SLL, atypical CLL/SLL, and MCL based on the flow cytometry immunophenotyping.

The diagnosis and differential diagnosis of typical lymphocytic leukaemia (CLL)/Small lymphocytic lymphoma(SLL) especially atypical CLL/SLL (aCLL/SLL), and mantle cell lymphoma (MCL) remains highly challenging. Thus, we evaluated the accuracy of the combination of the Moreau score system (MSS) indicators (markers), with three new indicators CD19/CD20 ratio, CD200, and CD43 in diagnosis and differential diagnosis of typical CLL/SLL, atypical CLL/SLL, and MCL. We retrospectively retrieved data from peripheral blood, bone marrow, and lymph nodes of 120 patients comprising 64 typical CLL, 10 atypical CLL, and 46 MCL from March 2020 to September 2023 at the First Affiliated Hospital of Zhengzhou University. Multiparametric evaluation flow cytometry and immunophenotype were obtained via a B-cell panel and pathological reports were carried out. We observe that the new score system (NSS) and the MSS had the same specificity. However, the NSS demonstrated to have superior sensitivity compared to MSS. Adding three new markers CD19/CD20, CD200, and CD43 is accountable for the superior sensitivity in our NSS. Also, a combination of markers such as CD19, CD20, CD5, CD23, CD79b, FMC7, SmIg, CD22, CD43, CD200, the ratio CD19/CD20 may be a potential differentiating modality for typical CLL/SLL, atypical CLL/SLL, and MCL. Adding the CD19/CD20 ratio, CD43, and CD200 indicators to the MSS indicators could be potentially accurate diagnostic and differential diagnosis modality for typical CLL/SLL, atypical CLL/SLL, and MCL.