Comparison of conventional cytomorphology, flow cytometry immunophenotyping, and automated cell counting of CSF for detection of CNS involvement in acute lymphoblastic leukemia

Comparison of conventional cytomorphology, flow cytometry immunophenotyping, and automated cell... INTRODUCTIONCentral nervous system (CNS) involvement is present in 5%‐10% of acute lymphoblastic leukemia (ALL) patients at diagnosis, conferring a poorer prognosis and requiring CNS‐directed therapy. Routinely, manual cell count (MCC) and microscopic examination are performed on cerebrospinal fluid (CSF) samples by standard optical microscopy in a Fuchs‐Rosenthal counting chamber. This manual procedure is time‐consuming and requires experienced technologists; these drawbacks could be improved with contemporary automated cell counters which incorporate a body fluid channel capable of analyzing and counting cells in CSF; importantly, this method does not discriminate between benign and malign cells and is not routinely used as a diagnostic option for CNS involvement in ALL. Cytospin conventional cytomorphology (CCC) evaluation after cytocentrifugation of the CSF is the gold standard for detection of lymphoblasts in ALL patients; this method is estimated to have a specificity greater than 95% for CNS infiltration but a low sensitivity of about 50% for identification of CNS disease. Recent data demonstrate that most of CNS relapses occur in patients without CNS involvement detected at diagnosis by CCC. Several studies have demonstrated that flow cytometry immunophenotyping (FCI) is a valuable tool that reliably detects phenotypically abnormal cells and is more sensitive than CCC analysis http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Laboratory Hematology Wiley

Comparison of conventional cytomorphology, flow cytometry immunophenotyping, and automated cell counting of CSF for detection of CNS involvement in acute lymphoblastic leukemia

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Publisher
Wiley
Copyright
Copyright © 2018 John Wiley & Sons Ltd
ISSN
1751-5521
eISSN
1751-553X
D.O.I.
10.1111/ijlh.12760
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONCentral nervous system (CNS) involvement is present in 5%‐10% of acute lymphoblastic leukemia (ALL) patients at diagnosis, conferring a poorer prognosis and requiring CNS‐directed therapy. Routinely, manual cell count (MCC) and microscopic examination are performed on cerebrospinal fluid (CSF) samples by standard optical microscopy in a Fuchs‐Rosenthal counting chamber. This manual procedure is time‐consuming and requires experienced technologists; these drawbacks could be improved with contemporary automated cell counters which incorporate a body fluid channel capable of analyzing and counting cells in CSF; importantly, this method does not discriminate between benign and malign cells and is not routinely used as a diagnostic option for CNS involvement in ALL. Cytospin conventional cytomorphology (CCC) evaluation after cytocentrifugation of the CSF is the gold standard for detection of lymphoblasts in ALL patients; this method is estimated to have a specificity greater than 95% for CNS infiltration but a low sensitivity of about 50% for identification of CNS disease. Recent data demonstrate that most of CNS relapses occur in patients without CNS involvement detected at diagnosis by CCC. Several studies have demonstrated that flow cytometry immunophenotyping (FCI) is a valuable tool that reliably detects phenotypically abnormal cells and is more sensitive than CCC analysis

Journal

International Journal of Laboratory HematologyWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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