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6106940 
Journal Article 
The utility of BRAF V600E mutation-specific antibody VE1 for the diagnosis of hairy cell leukemia 
Uppal, G; Ly, V; Wang, ZX; Bajaj, R; Solomides, CC; Banks, PM; Medeiros, LJ; Peiper, SC; Gong, JZ 
2015 
Yes 
American Journal of Clinical Pathology
ISSN: 0002-9173
EISSN: 1943-7722 
143 
1 
120-125 
English 
25511150 
OBJECTIVES: BRAF V600E mutation is characteristic of hairy cell leukemia (HCL). A V600E mutation-specific antibody, VE1, has been recently developed. We studied the diagnostic utility of this antibody in HCL and compared it with other B-cell neoplasms.

METHODS: VE1 activity was assessed using immunohistochemistry in 90 mature B-cell neoplasms, including HCL (n = 17), HCL variant (n = 6), chronic lymphocytic leukemia (CLL) (n = 20), and 47 other B-cell lymphomas. Most (87/90) specimens were formalin-fixed, paraffin-embedded bone marrow (BM) biopsy specimens decalcified in either hydrochloric acid or formic acid.

RESULTS: VE1 was positive in 15 (88%) cases of HCL and two (10%) cases of CLL and was negative in all other tumors assessed. The VE1-positive HCL cases showed uniform staining in all tumor cells, but intensity was variable. The two VE1-negative HCL cases had BRAF V600 mutations proven by molecular analysis. The two CLL cases positive with VE1 showed an atypical staining pattern with expression in a minority of lymphoma cells. Immunohistochemistry using the VE1 antibody had a sensitivity of 88% and a specificity of 97% for HCL.

CONCLUSIONS: VE1 immunohistochemistry is a useful and convenient surrogate for detecting BRAF V600E mutation in BM biopsy specimens decalcified with hydrochloric or formic acid-based solutions.