CD22

Immunity

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Flow cytometry panel of immune cell surface markers.

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CD22 Test Information Guide

Why is it done?
- CD22 is a B-cell surface antigen used in flow cytometry to identify and classify B-lymphocytes in blood and bone marrow samples
- Diagnosis of B-cell lymphomas and leukemias, including Chronic Lymphocytic Leukemia (CLL) and Diffuse Large B-cell Lymphoma (DLBCL)
- Monitoring B-cell populations in immunocompromised patients and those with immune disorders
- Assessment of response to targeted immunotherapy, particularly monoclonal antibody treatments like rituximab
- Characterization of abnormal B-cell populations in patients with persistent lymphocytosis or suspected hematologic malignancies
- Typically performed when a patient presents with unexplained lymphocytosis, suspected lymphoproliferative disorder, or as part of lymphoma staging and follow-up
Normal Range
- CD22 is expressed on mature B lymphocytes; normal range varies by laboratory but typical reference values are:
- B lymphocytes expressing CD22: 10-20% of total white blood cells or 400-1000 cells/μL
- Normal result (Negative): CD22 expression pattern consistent with normal B-cell population; CD22+ cells represent a small percentage of circulating lymphocytes
- Abnormal result (Positive): Increased CD22+ cells, abnormal B-cell population, or aberrant antigen expression pattern suggesting lymphoproliferative disorder
- Results are typically reported as percentage of total white blood cells or absolute cell count (cells/μL)
- Reference ranges may differ between laboratories; results must be interpreted in context with other flow cytometry markers and clinical findings
Interpretation
- Normal B-cell population: CD22 expression follows expected pattern on mature B lymphocytes; CD22+ cells represent normal percentage of total WBC count; typically seen in healthy individuals or patients without B-cell disorders
- Increased CD22+ cells: May indicate B-cell lymphoproliferative disorder, chronic lymphocytic leukemia, or other B-cell malignancies; often accompanied by increased absolute lymphocyte count
- Abnormal antigen expression pattern: Aberrant co-expression with other markers, loss of expected antigens, or unusual immunophenotype strongly suggests malignancy and assists in classification
- CD22 expression in combination with CD19: Both present on mature B cells; CD22+CD19+ indicates normal B-cell lineage; discordant expression patterns help identify abnormalities
- CD22 positive with abnormal immunophenotype: May include unusual surface marker combinations suggesting specific lymphoma subtypes (e.g., CLL vs. follicular lymphoma)
- Factors affecting interpretation: Patient age (pediatric vs. adult), disease stage, prior chemotherapy or immunotherapy, presence of infections, and concurrent medications may influence CD22 expression patterns
- Response to therapy: Declining CD22+ cell count during targeted therapy suggests treatment response; persistent or increasing levels may indicate resistance or relapse
Associated Organs
- Lymphoid system: Bone marrow (site of B-cell development), lymph nodes, and spleen (sites of B-cell proliferation and maturation)
- Circulatory system: Blood and peripheral circulation where CD22+ B lymphocytes circulate and can be measured
- Associated diseases with abnormal CD22 expression:
- Chronic Lymphocytic Leukemia (CLL): CD22+ B cells typically CD5+, CD19+, CD23+ with dim surface immunoglobulin expression
- Diffuse Large B-cell Lymphoma (DLBCL): CD22+ with typically brighter CD20 expression and often CD10 negative
- Follicular Lymphoma: CD22+ cells with CD10+, CD20+ phenotype typical of germinal center origin
- B-cell Acute Lymphoblastic Leukemia (B-ALL): CD22+ in early B-cell precursors (CD22+ CD19+/- pattern)
- Autoimmune disorders: Abnormal B-cell populations may show altered CD22 expression patterns in systemic lupus erythematosus (SLE) and rheumatoid arthritis
- Potential complications with abnormal results: Increased risk of infections due to impaired B-cell function, bleeding complications from bone marrow involvement, lymphadenopathy, splenomegaly, and potential organ infiltration
Follow-up Tests
- Additional flow cytometry markers: CD19, CD20, CD5, CD10, CD23, FMC7, and surface immunoglobulin (kappa/lambda) to further characterize B-cell populations
- Complete Blood Count (CBC): To assess overall lymphocyte count and differential, monitor for cytopenias
- Bone marrow biopsy and aspiration: If malignancy suspected to assess degree of marrow involvement
- LDH (Lactate Dehydrogenase): Prognostic marker for lymphomas; elevated levels suggest more aggressive disease
- Imaging studies: CT scan or PET-CT to assess for lymph node enlargement and organ involvement in suspected lymphoma
- Cytogenetic and molecular studies: FISH analysis for specific translocations (t(8;14), t(14;18)), gene mutation analysis when malignancy confirmed
- Immunoglobulin and light chain studies: To detect monoclonal proteins suggestive of B-cell malignancy
- Repeat flow cytometry: Typically every 3-6 months during monitoring of diagnosed lymphoproliferative disorder or during therapy to assess treatment response
- Minimal Residual Disease (MRD) monitoring: Sensitive flow cytometry to detect residual leukemic cells after therapy completion
- Liver and kidney function tests: To assess for organ involvement and to monitor for treatment-related toxicities
Fasting Required?
- Fasting Required: No
- CD22 testing via flow cytometry requires only a blood sample and does not require fasting; patients may eat and drink normally before the test
- Patient preparation requirements:
- No special preparation needed; routine venipuncture is performed to collect blood sample
- Blood collection: EDTA (lavender top) tube required for proper preservation of cell viability and accurate flow cytometry analysis
- Sample stability: Best results when sample is processed within 24-48 hours of collection; samples should be kept at room temperature in most laboratories
- Medications: No need to hold medications unless specifically instructed by physician; continue all routine medications unless otherwise advised
- Special instructions: Inform phlebotomist of any difficult venipuncture history; alert healthcare provider if patient is on anticoagulation therapy
- Timing: Can be performed at any time of day; no specific time restrictions apply to this test

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