CD 5

Immunity

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No Fasting Required

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Flow cytometry panel of immune cell surface markers.

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CD5 Test Information Guide

Why is it done?
- CD5 is a cluster of differentiation antigen used as a tumor marker and immunophenotyping tool to detect and classify certain types of lymphocytes and leukemias
- Diagnosis and classification of chronic lymphocytic leukemia (CLL) and other lymphoproliferative disorders
- Identification of B-cell and T-cell malignancies through flow cytometry analysis
- Monitoring disease progression and response to treatment in lymphoid malignancies
- Evaluation of patients presenting with lymphocytosis or abnormal white blood cell counts
- Assessment of autoimmune conditions where CD5+ B-cells may be abnormally expanded
Normal Range
- Normal CD5+ T-cells (adults): 60-85% of circulating lymphocytes or approximately 600-2,500 cells/μL (cells per microliter)
- CD5+ B-cells (normal range): Less than 5% of circulating B-cells; CD5+ B-cell counts typically <200 cells/μL
- Negative result: Absence of CD5 antigen expression; typically reassuring, rules out CD5-expressing malignancies
- Positive result: CD5 antigen expression detected; may indicate lymphoid malignancy or clonal expansion
- Elevated CD5+ B-cells: >5% of B-cells or >200 cells/μL; concerning for CLL, lymphoma, or autoimmune conditions
Interpretation
- CD5 Expression on T-cells: Normal and expected finding; present on mature T-lymphocytes as a pan-T-cell marker; helps identify T-cell populations in normal immune function
- CD5+ B-cells (abnormal elevation): B-cells normally do not express CD5; presence indicates abnormal B-cell clones; hallmark of chronic lymphocytic leukemia (CLL); may also indicate mantle cell lymphoma or autoimmune lymphoproliferative syndrome
- CLL-like pattern: CD5+, CD19+, CD23+ B-cells; confirms CLL diagnosis when combined with clinical presentation and lymphocytosis >5,000/μL
- Mantle cell lymphoma pattern: CD5+, CD19+, CD23- B-cells; distinguished from CLL by CD23 negativity; associated with poorer prognosis
- T-cell abnormalities: Abnormal CD5+ T-cell populations may indicate T-cell lymphoma, cutaneous T-cell lymphoma, or other T-cell malignancies
- Factors affecting interpretation: Flow cytometry methodology and gating strategies, specimen quality, timing of collection, concurrent infections, and other immunophenotypic markers must be considered together
Associated Organs
- Primary organ system: Lymphoid system (bone marrow, lymph nodes, spleen, thymus, peripheral blood)
- Chronic lymphocytic leukemia (CLL): CD5 is a hallmark marker; affects bone marrow, lymph nodes, spleen, and peripheral blood; typically affects older adults
- Mantle cell lymphoma: CD5+ aggressive B-cell lymphoma; involves lymph nodes, bone marrow, gastrointestinal tract; associated with cyclin D1 overexpression and t(11;14) translocation
- Small lymphocytic lymphoma (SLL): Tissue form of CLL; CD5+ B-cells in lymph nodes and extranodal sites
- T-cell lymphomas: Peripheral T-cell lymphomas, mycosis fungoides (cutaneous); abnormal CD5+ T-cell proliferation in skin and lymph nodes
- Autoimmune conditions: Systemic lupus erythematosus, rheumatoid arthritis, and autoimmune lymphoproliferative syndrome (ALPS); elevated CD5+ B-cells can occur
- Potential complications of abnormal results: Lymphadenopathy, hepatosplenomegaly, anemia, thrombocytopenia, infections, autoimmune cytopenias, transformation to aggressive lymphoma, and reduced survival
Follow-up Tests
- Comprehensive flow cytometry panel: CD19, CD20, CD23, FMC7, CD25, CD11b/c to further characterize B-cell malignancies
- Cytochemical staining: Tartrate-resistant acid phosphatase (TRAP), myeloperoxidase (MPO), and other special stains
- Cytogenetics and FISH studies: Detection of t(11;14), t(14;19), del(13q), del(11q), del(17p), TP53 mutations for prognostic stratification
- Complete blood count (CBC): Assess absolute lymphocyte count, hemoglobin, platelet count for cytopenias
- Metabolic panel and LDH: Elevated LDH indicates higher disease burden and aggressive disease
- Bone marrow biopsy: May be needed to assess marrow infiltration, staging, and prognostic factors
- Imaging studies: CT scan, PET-CT for staging lymphomas and assessing extent of disease
- Repeat flow cytometry: Every 3-6 months initially, then annually if stable, more frequently if treatment is initiated
- Immunoglobulin level testing: Assess for monoclonal proteins and immunoglobulin deficiency
Fasting Required?
- Fasting requirement: NO - Fasting is NOT required for CD5 testing
- Sample collection: Blood sample collected via venipuncture into EDTA (ethylenediaminetetraacetic acid) tube, typically purple-topped tube
- Timing considerations: Sample should be processed within 24-48 hours of collection for optimal results; avoid hemolysis and specimen degradation
- Medications to avoid: No specific medications need to be discontinued; however, inform laboratory of recent treatments (chemotherapy, steroids) that may affect results
- Special preparation: Patient can eat and drink normally; no special dietary restrictions; can take regular medications
- Transport and storage: Maintain room temperature; do not refrigerate or freeze; deliver to laboratory promptly for flow cytometry analysis

How our test process works!