Jonathan Fromm, MD, PhD
Assistant Professor, Laboratory Medicine
Associate Director of the Hematopathology Laboratory
Dr. Fromm is an Associate Director of the Hematopathology laboratory at the University of Washington. Dr. Fromm’s research interests are the pathobiology of lymphoma and developing new diagnostic methods for lymphoma.
Dr. Fromm and colleagues have recently demonstrated that classical Hodgkin lymphoma (CHL) in lymph nodes can be diagnosed by flow cytometry. This method is now being used clinically in our laboratory. CHL is unique type of B cell lymphoma where the neoplastic Hodgkin and Reed Sternberg (HRS) cells are embedded in a reactive cellular infiltrate comprised of lymphocytes, histiocytes, eosinophils, and plasma cells. Traditionally, evaluation of tissue sections by immunohistochemistry is required for the diagnosis of CHL. This novel 9 color flow cytometry assay is faster and less expensive than traditional diagnostic methods, and has a diagnostic sensitivity and specificity of approximately 90% and100%, respectively. Additionally, this research suggests that rare cases of CHL can be missed by traditional slide based methods and consequently, this assay provides a useful adjunct for diagnosing this neoplasm. Work is underway to: 1) identify novel antigens that are useful in diagnosing CHL by flow cytometry, 2) identify antigens which have prognostic significance in CHL, and 3) modify this technique to allow its use in other laboratories.
These initial flow cytometry studies also suggested that flow cytometric cell sorting (FCCS) could be used to purify viable neoplastic HRS cells. FCCS uses the principles of flow cytometry to purify cell populations with a specific antigen profiles. Current methods used to purify HRS cells require that the cells be manually cut out of a tissue section affording only individual cells; FCCS can yield thousands of HRS cells in a few hours. This purification method is currently being applied to probe the pathogenesis of CHL. The RNA expression profiles of purified HRS cells are being examined to help better understand how these cells proliferate and avoid apoptosis (programmed cell death). Such studies could provide the basis for new therapeutics for CHL.
For further information:
Department of Laboratory Medicine
University of Washington
Box 357110
Seattle, WA 98195
jfromm@u.washington.edu
Selected References
S.K. Kussick, J.R .Fromm, A. Rossini, Y. Li, A. Chang, T.H. Norwood, and B.L. Wood, “Flow cytometry shows strong concordance with bone marrow morphology and cytogenetics in the workup of myelodysplasia” American Journal of Clinical Pathology, (2005) 124, 170-181.
J.R .Fromm, S.K. Kussick, and B.L. Wood, “Identification and purification of classical Hodgkin cells from lymph nodes by flow cytometry and flow cytometric cell sorting” American Journal of Clinical Pathology, (2006) 126, 764-780.
G. Stetsenko, R. McFarlane, A. Kalus, J. Olerud, S. Cherian, J.R. Fromm, E. George, and Z. Argenyi, CD4+/CD56+ Hematodermic neoplasm: report of a rare variant with a T-cell receptor gene rearrangement” Journal of Cutaneous Pathology, (2008), 35, 579-584.
M. Roshal, B.G. Till, J. R. Fromm, S. Cherian, Intravascular large B cell lymphoma presenting in a liver explant, Journal of Clinical Pathology, (2008) 61, 877-878.
J.R .Fromm, A. Thomas, and B.L. Wood, “Flow cytometry can diagnose classical Hodgkin lymphoma in lymph nodes with high sensitivity and specificity” American Journal of Clinical Pathology, in press.
Last updated: 10/06/08