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Reading an immunophenotyping panel, line by line | CION Cancer Clinics
An immunophenotyping report shows which proteins, labelled with CD numbers, sit on the abnormal cells. The pattern, not any single marker, names the cell type: myeloid markers point to AML, B cell markers with TdT to B-lymphoblastic leukaemia. Start with the impression at the end of the report. This page walks through each section and explains what dim, bright and aberrant mean. At CION Cancer Clinics, our haematologist reviews abnormal blood reports with you, orders only the tests that answer your question and explains each result plainly.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- What is an immunophenotyping report telling you?
- How is a typical panel report laid out?
- What do the most common markers point to?
- What do dim, bright, partial and aberrant mean?
- Which marker patterns go with which blood cancers?
- What do families often misread on a marker panel?
- What can the panel not tell you?
- Common questions about immunophenotyping reports
The short answer
What is an immunophenotyping report telling you?
An immunophenotyping report lists which proteins were found on the surface or inside the abnormal cells. Each protein has a CD number, such as CD19 or CD33. The pattern of positives and negatives shows what type of cell it is, and that pattern is what names the blood cancer.
Read the conclusion first
Most reports end with an impression or interpretation, a few lines in plain medical language. Something like "consistent with B-lymphoblastic leukaemia" or "no abnormal population detected". Start there. The long list of markers above it is the evidence for that conclusion, written for your haematologist.
No single marker decides it
Many markers appear on more than one kind of cell. CD34, for example, is found on young cells of several families. The laboratory looks at the whole combination. This is why you cannot take one line of the report, search it online and reach the right answer. The pattern matters more than any one entry.
Your report may call this test flow cytometry. The machine is flow cytometry; immunophenotyping is what it produces. Some markers are also checked on biopsy tissue with stains.Section by section
How is a typical panel report laid out?
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Sample details
Blood, marrow or fluid, the date collected and date received. A long gap or a note about a clotted or diluted sample tells you the result may be less certain.
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Viability
How many cells were still alive when tested. Low viability can make markers harder to read.
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The population studied
The laboratory "gates" on a group of cells, meaning it selects them for closer study. The report says which group, such as blasts or lymphocytes, and what share of all cells it makes up.
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The marker list
Each CD number with a result: positive, negative, dim, bright or partial. Some reports add a percentage of cells positive.
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Impression
The laboratory's conclusion, often with a suggestion to correlate with the marrow smear, chromosome or gene tests.
Not sure whether this applies to you?
Ask an oncologistOn your report
What do the most common markers point to?
- CD45
- Found on almost all white cells. Blasts usually carry less of it, shown as "dim".
- CD34, HLA-DR
- Found on young, immature cells. They help show a group of cells are blasts.
- CD13, CD33, CD117, MPO
- Myeloid markers. They point to cells heading towards granulocytes or monocytes, as in AML.
- CD19, CD22, CD79a, CD10
- B cell markers. With TdT, an immature-cell marker, they point to B-lymphoblastic leukaemia.
- cCD3, CD7, CD5, CD2
- T cell markers. Cytoplasmic CD3, found inside the cell, is the key one for T-lineage.
- CD38, CD138
- Plasma cell markers, looked at when myeloma is the question.
Positive is not the whole story
What do dim, bright, partial and aberrant mean?
A marker is not simply there or not there. The report also describes how much of it each cell carries, and how many cells carry it. These details often matter as much as the positive or negative result.
Dim and bright
Dim means the protein is present, but less than on normal cells. Bright means more than usual. In chronic lymphocytic leukaemia, for example, CD20 is typically dim, which is part of the recognised pattern. A normal cell and an abnormal cell can both be "positive" and still differ in brightness.
Partial or heterogeneous
Only some of the studied cells carry the marker. It can mean the population is mixed, or that the cells are at different stages of maturing.
Aberrant expression
A marker that normally belongs to another family appears on these cells, for example a T cell marker on myeloid blasts. This is a useful clue that the cells are abnormal, and it helps track them after treatment. It does not by itself mean a worse disease.
Kappa and lambda
B cells carry one of two light chains, kappa or lambda. A healthy mix has both. When nearly all the B cells carry only one, the report says "light chain restricted", which suggests a single abnormal family of cells.
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Recognised patterns
Which marker patterns go with which blood cancers?
These are typical patterns only. Real reports vary, and your haematologist reads them with every other result.
Acute myeloid leukaemia
Blasts with myeloid markers and usually no B or T lineage markers.
- CD34, CD117, HLA-DR often positive
- CD13, CD33, MPO positive
B-lymphoblastic leukaemia
Immature B cells, the most common form of ALL in children and adults.
- CD19, CD22, CD79a positive
- TdT and often CD10 positive
T-lymphoblastic leukaemia
Immature T cells. Sometimes it presents with a mass in the chest.
- Cytoplasmic CD3 positive
- CD7 and TdT positive
Chronic lymphocytic leukaemia
Mature, small B cells with a very recognisable pattern.
- CD5, CD19, CD23, CD200 positive
- Dim CD20 and dim light chain
Commonly believed
What do families often misread on a marker panel?
"CD34 positive means cancer."
CD34 is found on normal young cells in every healthy marrow. It helps show cells are immature. Whether they are abnormal depends on how many there are and what else they carry.
"More positive markers means a more aggressive cancer."
The number of positives describes the cell type. It is not a measure of how serious the disease is. Outlook depends on the type, its chromosome and gene changes, and how it responds.
"A marker from the wrong family means the lab made a mistake."
Aberrant markers are common in leukaemia and are a real finding. They often help the team follow the disease later. Rarely, the cells carry two families equally, and the report will say so.
"We can read the markers ourselves and skip the appointment."
The pattern is read against your smear, your counts and your gene results. A search on one CD number gives a misleading answer far more often than a helpful one.
Being straight with you
What can the panel not tell you?
The panel names the cell type. It cannot set the risk group, choose the treatment or predict how things will go. Those decisions need the chromosome and gene results, your age and fitness, and how the disease responds. Some markers do matter for treatment, such as CD20 or CD19, because certain medicines target them. Your haematologist will explain if that applies to you.
Questions worth asking
Ask what the impression means in plain words. Ask whether any marker affects treatment choice. Ask whether a baseline pattern has been noted for tracking after treatment. Ask which tests are still pending. At CION, our haematology team reads the panel with the rest of your results, presents the case to a tumour board, and coordinates further testing with qualified laboratories.
Marker panels and reporting styles differ between laboratories. Keep the full report, not only the impression.Questions we are asked
Common questions about immunophenotyping reports
What does "CD" stand for?
CD stands for cluster of differentiation. It is an international naming system for proteins found on blood cells. Each protein gets a number, so CD19 means the same protein in every laboratory. The numbers are labels only; a higher number is not more serious.
What does "no abnormal population" mean?
The laboratory did not find a group of cells with an abnormal marker pattern in the sample tested. That is reassuring. It applies to that sample, so your haematologist reads it with your counts, smear and symptoms before drawing a final conclusion.
What is mixed phenotype acute leukaemia?
It is a rare leukaemia where the blasts carry strong markers of two families, such as myeloid and B cell, or blasts of two families exist together. It is diagnosed using strict criteria. Treatment is planned carefully, and gene and chromosome results matter a great deal.
Why is CD20 mentioned so often?
CD20 is found on most B cells. It matters because some antibody medicines target it, so knowing whether the cancer cells carry it can affect treatment choice in lymphoma and some leukaemias. Your haematologist decides whether such a medicine fits.
What does TdT positive mean?
TdT is a protein found inside very immature lymphoid cells. When blasts are TdT positive, it points towards a lymphoblastic leukaemia or lymphoma rather than a mature lymphoid cancer. It is read together with the B or T cell markers.
Why does the report give a percentage of cells?
It shows how large the abnormal group is compared with all the cells studied. It can differ from the microscope count, because the two methods handle the sample differently. Your haematologist uses both, and the microscope count is usually the one used for diagnostic thresholds.
Can the panel be repeated after treatment?
Yes. After treatment, a sensitive version of the test looks for any cells with the original abnormal pattern. This is called minimal residual disease testing. It works best when the first report recorded the pattern clearly.
Should the panel be reviewed by another laboratory?
It is reasonable if the report is unclear, the pattern is unusual, or the diagnosis will change treatment. Flow cytometry needs fresh cells, so a review may mean looking at the saved data files or sending a new sample. Ask your haematologist whether any delay is safe.
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Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- National Cancer Institute — Definition of immunophenotyping
- American Cancer Society — Tests for Acute Myeloid Leukemia (AML)
- American Cancer Society — Tests for Chronic Lymphocytic Leukemia
- Cancer.Net — Leukemia - Acute Lymphocytic - ALL: Diagnosis
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Flow Cytometry in Blood Cancer: What It DecidesThe test behind the panel, and what it decidesKaryotype and FISH in Leukaemia: Why They Change TreatmentThe chromosome tests read alongside itMinimal Residual Disease: The Number After TreatmentHow the pattern is tracked after treatmentLeukaemia guideThe wider picture if leukaemia is confirmed
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