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Enumeration of CD34+ blasts by immunohistochemistry in bone marrow biopsies from MDS patients may have significant impact on final WHO classification. J Hematop 2020. [DOI: 10.1007/s12308-020-00394-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
AbstractThe percentage of blasts cells in the bone marrow (BM) of MDS patients is one of the key parameters for MDS classification and for the differential diagnosis with acute myeloid leukemia (AML). Currently, the gold standard to determine the blast percentage is conventional cytomorphology. To assess the possible impact of blast cell enumeration in BM biopsies from MDS patients on the final WHO classification using CD34 immunohistochemistry (IHC) a total of 156 BM samples from MDS and MDS-AML patients were studied and compared to blast counts by cytomorphology (CM). Eighty-nine BM aspirates were also studied by flow cytometry (FCM). Percentages of CD34+ blasts by IHC were determined blindly by two hematopathologists. Automated CD34-cell count was performed in 25 cases. Good overall agreement was found for CM and FCM with respect to critical blast thresholds (5%, 10%, 20%) (p < 0.05). However, in 17% of patients, CD34+ blast counts by IHC were higher as compared to CM with possible impact on MDS subclassification. In 7 of 21 AML patients, diagnosis was established on BM histology, while the blast percentage by CM was below the AML threshold. The assessment of CD34+ cells by IHC showed high interobserver agreement (Spearman R 0.95, p < 0.01), while automated CD34 counts were not optimal due to interference with other cellular and stromal elements. BM histology including CD34 IHC improves the diagnostic accuracy in MDS and AML. The quantification of blast cells should be based on the integration of all three methods for reliable disease classification and risk assessment.
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Feng R, Bhatt VR, Fu K, Pirruccello S, Yuan J. Application of immunophenotypic analysis in distinguishing chronic myelomonocytic leukemia from reactive monocytosis. CYTOMETRY PART B-CLINICAL CYTOMETRY 2018; 94:901-909. [DOI: 10.1002/cyto.b.21721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/29/2018] [Accepted: 06/21/2018] [Indexed: 01/29/2023]
Affiliation(s)
- Ru Feng
- Departments of HematologyBeijing Hospital, National Center of Gerontology Beijing People's Republic of China
| | - Vijaya Raj Bhatt
- Department of Internal Medicine, Division of Hematology and OncologyUniversity of Nebraska Medical Center Omaha Nebraska
| | - Kai Fu
- Department of Pathology and MicrobiologyUniversity of Nebraska Medical Center Omaha Nebraska
| | - Samuel Pirruccello
- Department of Pathology and MicrobiologyUniversity of Nebraska Medical Center Omaha Nebraska
| | - Ji Yuan
- Department of Pathology and MicrobiologyUniversity of Nebraska Medical Center Omaha Nebraska
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Huang M, Zhao X, Xu H, Liu S, Wang Z, Sui X, Li J. Correlation Between Bone Marrow Blasts Counts With Flow Cytometry and Morphological Analysis in Myelodysplastic Syndromes. Ann Lab Med 2017. [PMID: 28643497 PMCID: PMC5500747 DOI: 10.3343/alm.2017.37.5.450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Min Huang
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Xinya Zhao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.
| | - Hongzhi Xu
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Suqing Liu
- Department of Nephrology, Shandong Provincial Hospital Group, Heze Municipal Hospital, Shandong, China
| | - Zie Wang
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Xiaohui Sui
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Jing Li
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
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Lambert C, Sack U. Monocytes and macrophages in flow cytometry. CYTOMETRY PART B-CLINICAL CYTOMETRY 2017; 92:178-179. [DOI: 10.1002/cyto.b.21530] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Claude Lambert
- Immunology Laboratory, CNRS UMR5307 Labo Georges Friedel (LGF); Pole de Biologie-Pathologie, University Hospital; St Etienne France
| | - Ulrich Sack
- Institute of Clinical Immunology, Medical Faculty; Universität Leipzig; Leipzig Germany
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Li S, Jaye DL, Bradley KT, Zhang L, Saxe D, Deeb G, Hill CE, Mann KP. Multimodality Technologies in the Assessment of Hematolymphoid Neoplasms. Arch Pathol Lab Med 2017; 141:341-354. [DOI: 10.5858/arpa.2016-0260-sa] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Accurate assessment of tissues for hematolymphoid neoplasms requires an integrated multiparameter approach. Although morphologic examination by light microscopy remains the mainstay of initial assessment for hematolymphoid neoplasms, immunophenotypic analysis by immunohistochemistry and/or flow cytometry is essential to determine the pattern of differentiation and to detect minimal disease when morphology is inconclusive. In some cases, immunophenotypic analysis provides additional information for targeted immunotherapy and prognostication. Genotypic studies, including cytogenetics, fluorescence in situ hybridization, DNA microarray, polymerase chain reaction, and/or next-generation sequencing, are also imperative for subclassification of the genetically defined disease entities in the current World Health Organization classification of hematolymphoid neoplasms. Moreover, genotypic studies can establish clonality, stratify patients to determine appropriate treatment, and monitor patients for treatment response.
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Affiliation(s)
| | | | | | | | | | | | | | - Karen P. Mann
- From the Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
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