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Altube A, Marsol N, Rey Deutsch AC, Malusardi C, Sciaccaluga D, Cabral C, Auat M. Detection of normal B cell precursors in lymph nodes samples. Int J Lab Hematol 2023; 45:592-595. [PMID: 36797825 DOI: 10.1111/ijlh.14037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/24/2023] [Indexed: 02/18/2023]
Affiliation(s)
- Alejandra Altube
- Flow Cytometry Laboratory, Hematology Division, Hospital de Clínicas "José de San Martín", University of Buenos Aires, Buenos Aires, Argentina
| | - Nicolás Marsol
- Hematology Division, Hospital de Clínicas "José de San Martín", University of Buenos Aires, Buenos Aires, Argentina
| | - Ana Clara Rey Deutsch
- Hematology Division, Hospital de Clínicas "José de San Martín", University of Buenos Aires, Buenos Aires, Argentina
| | - Cecilia Malusardi
- Flow Cytometry Laboratory, Hematology Division, Hospital de Clínicas "José de San Martín", University of Buenos Aires, Buenos Aires, Argentina
| | - Dolores Sciaccaluga
- Pathology Department, Hospital de Clínicas "José de San Martín", University of Buenos Aires, Buenos Aires, Argentina
| | - Cecilia Cabral
- Pathology Department, Hospital de Clínicas "José de San Martín", University of Buenos Aires, Buenos Aires, Argentina
| | - Mariangeles Auat
- Flow Cytometry Laboratory, Hematology Division, Hospital de Clínicas "José de San Martín", University of Buenos Aires, Buenos Aires, Argentina
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Porwit A, Béné MC, Duetz C, Matarraz S, Oelschlaegel U, Westers TM, Wagner-Ballon O, Kordasti S, Valent P, Preijers F, Alhan C, Bellos F, Bettelheim P, Burbury K, Chapuis N, Cremers E, Della Porta MG, Dunlop A, Eidenschink-Brodersen L, Font P, Fontenay M, Hobo W, Ireland R, Johansson U, Loken MR, Ogata K, Orfao A, Psarra K, Saft L, Subira D, Te Marvelde J, Wells DA, van der Velden VHJ, Kern W, van de Loosdrecht AA. Multiparameter flow cytometry in the evaluation of myelodysplasia: Analytical issues: Recommendations from the European LeukemiaNet/International Myelodysplastic Syndrome Flow Cytometry Working Group. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2023; 104:27-50. [PMID: 36537621 PMCID: PMC10107708 DOI: 10.1002/cyto.b.22108] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/20/2022] [Accepted: 11/29/2022] [Indexed: 01/18/2023]
Abstract
Multiparameter flow cytometry (MFC) is one of the essential ancillary methods in bone marrow (BM) investigation of patients with cytopenia and suspected myelodysplastic syndrome (MDS). MFC can also be applied in the follow-up of MDS patients undergoing treatment. This document summarizes recommendations from the International/European Leukemia Net Working Group for Flow Cytometry in Myelodysplastic Syndromes (ELN iMDS Flow) on the analytical issues in MFC for the diagnostic work-up of MDS. Recommendations for the analysis of several BM cell subsets such as myeloid precursors, maturing granulocytic and monocytic components and erythropoiesis are given. A core set of 17 markers identified as independently related to a cytomorphologic diagnosis of myelodysplasia is suggested as mandatory for MFC evaluation of BM in a patient with cytopenia. A myeloid precursor cell (CD34+ CD19- ) count >3% should be considered immunophenotypically indicative of myelodysplasia. However, MFC results should always be evaluated as part of an integrated hematopathology work-up. Looking forward, several machine-learning-based analytical tools of interest should be applied in parallel to conventional analytical methods to investigate their usefulness in integrated diagnostics, risk stratification, and potentially even in the evaluation of response to therapy, based on MFC data. In addition, compiling large uniform datasets is desirable, as most of the machine-learning-based methods tend to perform better with larger numbers of investigated samples, especially in such a heterogeneous disease as MDS.
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Affiliation(s)
- Anna Porwit
- Division of Oncology and Pathology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Marie C Béné
- Hematology Biology, Nantes University Hospital, CRCINA Inserm 1232, Nantes, France
| | - Carolien Duetz
- Department of Hematology, Amsterdam UMC, VU University Medical Center Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Sergio Matarraz
- Cancer Research Center (IBMCC-USAL/CSIC), Department of Medicine and Cytometry Service, Institute for Biomedical Research of Salamanca (IBSAL) and CIBERONC, University of Salamanca, Salamanca, Spain
| | - Uta Oelschlaegel
- Department of Internal Medicine, University Hospital Carl-Gustav-Carus, TU Dresden, Dresden, Germany
| | - Theresia M Westers
- Department of Hematology, Amsterdam UMC, VU University Medical Center Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Orianne Wagner-Ballon
- Department of Hematology and Immunology, Assistance Publique-Hôpitaux de Paris, University Hospital Henri Mondor, Créteil, France
- Inserm U955, Université Paris-Est Créteil, Créteil, France
| | | | - Peter Valent
- Department of Internal Medicine I, Division of Hematology & Hemostaseology and Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Frank Preijers
- Laboratory of Hematology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Canan Alhan
- Department of Hematology, Amsterdam UMC, VU University Medical Center Cancer Center Amsterdam, Amsterdam, The Netherlands
| | | | - Peter Bettelheim
- Department of Hematology, Ordensklinikum Linz, Elisabethinen, Linz, Austria
| | - Kate Burbury
- Department of Haematology, Peter MacCallum Cancer Centre, & University of Melbourne, Melbourne, Australia
| | - Nicolas Chapuis
- Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Cochin Hospital, Paris, France
- Institut Cochin, INSERM U1016, CNRS UMR, Université de Paris, Paris, France
| | - Eline Cremers
- Division of Hematology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Matteo G Della Porta
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alan Dunlop
- Department of Haemato-Oncology, Royal Marsden Hospital, London, UK
| | | | - Patricia Font
- Department of Hematology, Hospital General Universitario Gregorio Marañon-IiSGM, Madrid, Spain
| | - Michaela Fontenay
- Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Cochin Hospital, Paris, France
- Institut Cochin, INSERM U1016, CNRS UMR, Université de Paris, Paris, France
| | - Willemijn Hobo
- Department of Internal Medicine I, Division of Hematology & Hemostaseology and Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Robin Ireland
- Department of Haematology and SE-HMDS, King's College Hospital NHS Foundation Trust, London, UK
| | - Ulrika Johansson
- Laboratory Medicine, SI-HMDS, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Kiyoyuki Ogata
- Metropolitan Research and Treatment Centre for Blood Disorders (MRTC Japan), Tokyo, Japan
| | - Alberto Orfao
- Cancer Research Center (IBMCC-USAL/CSIC), Department of Medicine and Cytometry Service, Institute for Biomedical Research of Salamanca (IBSAL) and CIBERONC, University of Salamanca, Salamanca, Spain
| | - Katherina Psarra
- Department of Immunology - Histocompatibility, Evangelismos Hospital, Athens, Greece
| | - Leonie Saft
- Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital and Institute Solna, Stockholm, Sweden
| | - Dolores Subira
- Department of Hematology, Flow Cytometry Unit, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Jeroen Te Marvelde
- Laboratory Medical Immunology, Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Vincent H J van der Velden
- Laboratory Medical Immunology, Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Arjan A van de Loosdrecht
- Department of Hematology, Amsterdam UMC, VU University Medical Center Cancer Center Amsterdam, Amsterdam, The Netherlands
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Porwit A, Violidaki D, Axler O, Lacombe F, Ehinger M, Béné MC. Unsupervised cluster analysis and subset characterization of abnormal erythropoiesis using the bioinformatic Flow-Self Organizing Maps algorithm. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2022; 102:134-142. [PMID: 35150187 PMCID: PMC9306598 DOI: 10.1002/cyto.b.22059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/20/2021] [Accepted: 01/25/2022] [Indexed: 01/27/2023]
Abstract
Background The Flow‐Self Organizing Maps (FlowSOM) artificial intelligence (AI) program, available within the Bioconductor open‐source R‐project, allows for an unsupervised visualization and interpretation of multiparameter flow cytometry (MFC) data. Methods Applied to a reference merged file from 11 normal bone marrows (BM) analyzed with an MFC panel targeting erythropoiesis, FlowSOM allowed to identify six subpopulations of erythropoietic precursors (EPs). In order to find out how this program would help in the characterization of abnormalities in erythropoiesis, MFC data from list‐mode files of 16 patients (5 with non‐clonal anemia and 11 with myelodysplastic syndrome [MDS] at diagnosis) were analyzed. Results Unsupervised FlowSOM analysis identified 18 additional subsets of EPs not present in the merged normal BM samples. Most of them involved subtle unexpected and previously unreported modifications in CD36 and/or CD71 antigen expression and in side scatter characteristics. Three patterns were observed in MDS patient samples: i) EPs with decreased proliferation and abnormal proliferating precursors, ii) EPs with a normal proliferating fraction and maturation defects in late precursors, and iii) EPs with a reduced erythropoietic fraction but mostly normal patterns suggesting that erythropoiesis was less affected. Additionally, analysis of sequential samples from an MDS patient under treatment showed a decrease of abnormal subsets after azacytidine treatment and near normalization after allogeneic hematopoietic stem‐cell transplantation. Conclusion Unsupervised clustering analysis of MFC data discloses subtle alterations in erythropoiesis not detectable by cytology nor FCM supervised analysis. This novel AI analytical approach sheds some new light on the pathophysiology of these conditions.
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Affiliation(s)
- Anna Porwit
- Department of Clinical Sciences, Oncology and Pathology, Lund University, Faculty of Medicine, Lund, Sweden.,Department of Clinical Genetics and Pathology, Skåne University Hospital, Lund, Sweden
| | - Despoina Violidaki
- Department of Clinical Sciences, Oncology and Pathology, Lund University, Faculty of Medicine, Lund, Sweden.,Department of Clinical Genetics and Pathology, Skåne University Hospital, Lund, Sweden
| | - Olof Axler
- Department of Clinical Sciences, Oncology and Pathology, Lund University, Faculty of Medicine, Lund, Sweden.,Department of Clinical Genetics and Pathology, Skåne University Hospital, Lund, Sweden
| | - Francis Lacombe
- Hematology Biology, Bordeaux University Hospital Haut Leveque, Bordeaux, France
| | - Mats Ehinger
- Department of Clinical Sciences, Oncology and Pathology, Lund University, Faculty of Medicine, Lund, Sweden.,Department of Clinical Genetics and Pathology, Skåne University Hospital, Lund, Sweden
| | - Marie C Béné
- Hematology Biology, Nantes University Hospital & CRCINA, Nantes, France
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Wang W, Li Y, Ali H, Zhao L, Mei D, Hu W, Jiang B. Aberrant expression of CD54 detected by flow cytometry is a characteristic of B-lymphoma cells in bone marrow specimens. BMC Cancer 2021; 21:1315. [PMID: 34879826 PMCID: PMC8653582 DOI: 10.1186/s12885-021-09061-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/29/2021] [Indexed: 11/24/2022] Open
Abstract
Background Flow cytometry (FC) is a popular method to detect bone marrow (BM) involvement in patients with B-cell non-Hodgkin lymphoma (B-NHL). The majority of screen panels of FC still rely on finding monoclonal B-cells, e.g., B-cells with immunoglobin (Ig) light-chain restriction, which has many limitations. Therefore, exploring new markers is warranted. Methods A total of 52 cases of B-NHL with BM involvement were collected. The median age was 60 years. Out of these 52 cases, 34 were male, and 18 were female. A 10-color FC panel was used to detect the expression of CD54 on lymphoma cells. The expression of CD54 was calculated as the mean fluorescence index ratio (MFIR) and was described as the mean ± standard error of the mean (SEM). Results Up to 18/52 (34.62%) of BM specimens abnormally expressed an increased level of CD54, including 1/10 cases of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), 9/13 cases of mantle cell lymphoma (MCL), 2/14 cases of follicular lymphoma (FL), 5/9 cases of marginal zone lymphoma (MZL), and 1/3 cases of high-grade B-NHL (HG B-NHL). The expression level of CD54 was significantly increased in MCL cases (53.41 ± 11.04) compared with CLL/SLL cases (11.66 ± 2.79) and FL cases (13.49 ± 2.81). The lowest percentage of CD54-positive B-cells attained 0.13%. In 5/9 cases of MZL and 1/3 cases of HG B-NHL, increased expression of CD54 was the only abnormal immunophenotype detected besides Ig light-chain restriction. No aberrant CD54 expression was identified by FC in lymphoplasmacytic lymphoma (LPL) (0/2) and Burkitt lymphoma (BL) (0/1) cases. Aberrant expression of CD54 was not related to plasma cell differentiation. Conclusion Lymphoma cells, especially in MCL and MZL cases, frequently show increased expression of CD54. Such aberrant expression is not related to plasma cell differentiation. We highly recommend adding CD54 to the FC screening panel to detect BM involvement in patients with B-NHL.
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Affiliation(s)
- Wei Wang
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, USA
| | - Yan Li
- Department of Hematology, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Haval Ali
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, USA
| | - Linjun Zhao
- Department of Lymphoma, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Di Mei
- Department of Lymphoma, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Wenqing Hu
- Department of Hematology, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Bin Jiang
- Department of Hematology, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China.
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Pembroke JS, Joseph JE, Smith SABC, Parker AJC, Jiang W, Sewell WA. Comparison of flow cytometry with other modalities in the diagnosis of myelodysplastic syndrome. Int J Lab Hematol 2021; 44:313-319. [PMID: 34841680 DOI: 10.1111/ijlh.13771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 10/14/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The myelodysplastic syndromes (MDSs) are heterogeneous myeloid malignancies, conventionally diagnosed by cytomorphology and cytogenetics, with an emerging role for flow cytometry. This study compared the performance of a 4-parameter flow cytometry scoring system, the Ogata Score, with other modalities in the diagnosis of MDS. METHODS Bone marrow aspirate and trephine biopsies from 238 patients performed to assess for possible MDS were analysed, and the flow cytometry score was retrospectively applied. The sensitivity and specificity of the flow cytometry score, the aspirate microscopy, the trephine microscopy with immunohistochemistry, and cytogenetic and molecular results were determined relative to the final diagnosis. RESULTS The medical records of the 238 patients were reviewed to determine the final clinical diagnosis made at the time of the bone marrow examination. This final diagnosis of MDS, possible MDS or not MDS, was based on clinical features and laboratory tests, including all parameters of the bone marrow investigation, except for the flow cytometry score, which was only determined for this study. The flow cytometry score was 67.4% sensitive and 93.8% specific. Aspirate microscopy had higher sensitivity (83.7%) and similar specificity (92.0%), whereas trephine microscopy had similar sensitivity (66.3%) and specificity (89.4%) to flow cytometry. Although the flow cytometry score had a lower sensitivity than aspirate microscopy, in 18 patients (7.6% of the total) the flow cytometry score was positive for MDS, whereas aspirate microscopy was negative or inconclusive. CONCLUSION The flow cytometry score and trephine microscopy exhibited reasonable sensitivity and high specificity, and complement aspirate microscopy in the assessment of MDS.
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Affiliation(s)
- John S Pembroke
- St Vincent's Clinical School, University of New South Wales Sydney, Sydney, Australia.,St Vincent's Pathology (SydPath), St Vincent's Hospital, Sydney, Australia
| | - Joanne E Joseph
- St Vincent's Clinical School, University of New South Wales Sydney, Sydney, Australia.,St Vincent's Pathology (SydPath), St Vincent's Hospital, Sydney, Australia.,Haematology Department, St Vincent's Hospital, Sydney, Australia
| | - Sandy A B C Smith
- St Vincent's Pathology (SydPath), St Vincent's Hospital, Sydney, Australia
| | - Andrew J C Parker
- St Vincent's Pathology (SydPath), St Vincent's Hospital, Sydney, Australia
| | - Wei Jiang
- St Vincent's Pathology (SydPath), St Vincent's Hospital, Sydney, Australia.,Haematology Department, St Vincent's Hospital, Sydney, Australia
| | - William A Sewell
- St Vincent's Clinical School, University of New South Wales Sydney, Sydney, Australia.,St Vincent's Pathology (SydPath), St Vincent's Hospital, Sydney, Australia.,Garvan Institute of Medical Research, Sydney, Australia
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Béné MC. Issue Highlights-September 2021. CYTOMETRY PART B-CLINICAL CYTOMETRY 2021; 100:537-540. [PMID: 34536066 DOI: 10.1002/cyto.b.22031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Marie C Béné
- Hematology Biology, Nantes University Hospital, Inserm 1232, CRCINA, Nantes, France
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Chauhan R, Singh J, Sharma C, Dange P, Chopra A, Mahapatra M, Pati H. The utility of a single tube 10-color flow cytometry for quantitative and qualitative analysis in myelodysplastic syndrome- a pilot study. Leuk Res 2021; 107:106651. [PMID: 34218155 DOI: 10.1016/j.leukres.2021.106651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 06/19/2021] [Accepted: 06/28/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Assessment of myelodysplasia (MDS) by flow cytometry (FCM) includes elaborate panels, and interpretation is observer-dependent. This study evaluates single tube 10-color FCM in a test cohort of clinically suspected MDS patients. METHODS We analyzed fifty-six bone marrow (BM) samples from clinically suspected MDS patients in a morphology-blinded manner along with controls using a 10-color single tube flow cytometry. We analyzed the reproducibility of Ogata score and modified FCM scores, additionally incorporating the proportion of CD15, CD11b, CD56, and CD38MFI on CD34+CD19-cluster for each patient. Patients were grouped as proven-MDS, suspected-MDS, and non-MDS groups based on morphology and cytogenetics. Optimized multi-axial radar-plots were also used to analyze maturation patterns in the granulocytic, monocytic, and blast progenitor compartments of proven-MDS cases and controls. RESULTS Flow cytometric abnormalities ≥3 were present in proven-MDS (n = 23) with a sensitivity and specificity of 78 % and 94 %, respectively, as per Ogata score. The addition of CD38 MFI to the score yielded sensitivity and specificity of 82 % and 88 %, respectively. Additional analysis of aberrant expression of CD15, CD11b, and CD56 increased the diagnostic power of the FCM score. A qualitative analysis of data also showed differences in maturation patterns in proven-MDS compared to the control group. CONCLUSION Single tube 10-color FCM scoring, including Ogata score, modified-FCM scores, and radar plots pattern analysis, showed significant abnormalities in proven-MDS cases in this pilot study. Large databases, including FCM-scoring and pattern-based analysis for normal BM maturation, could be further validated and standardized for screening MDS.
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Affiliation(s)
- Richa Chauhan
- Department of Hematology, Sir Ganga Ram Hospital, New Delhi, India
| | - Jay Singh
- Department of Laboratory Oncology, B.R.A.I.R.C.H., AIIMS, New Delhi, India
| | - Charu Sharma
- Department of Mathematics, Shiv Nadar University, Noida, U.P, India
| | - Prasad Dange
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Anita Chopra
- Department of Laboratory Oncology, B.R.A.I.R.C.H., AIIMS, New Delhi, India.
| | - Manoranjan Mahapatra
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Haraparasad Pati
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
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Gupta M, Jafari K, Rajab A, Wei C, Mazur J, Tierens A, Hyjek E, Musani R, Porwit A. Radar plots facilitate differential diagnosis of acute promyelocytic leukemia and NPM1+ acute myeloid leukemia by flow cytometry. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:409-420. [PMID: 33301193 PMCID: PMC8359362 DOI: 10.1002/cyto.b.21979] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/09/2020] [Accepted: 11/24/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Acute promyelocytic leukemia (APL) is one of the most life-threatening hematological emergencies and requires a prompt correct diagnosis by cytomorphology and flow cytometry (FCM) with later confirmation by cytogenetics/molecular genetics. However, nucleophosmin 1 muted acute myeloid leukemia (NPM1+ AML) can mimic APL, especially the hypogranular variant of APL. Our study aimed to develop a novel, Radar plot-based FCM strategy to distinguish APLs and NPM1+ AMLs quickly and accurately. METHOD Diagnostic samples from 52 APL and 32 NPM1+ AMLs patients were analyzed by a 3-tube panel of 10-color FCM. Radar plots combining all markers were constructed for each tube. Percentages of positive leukemic cells and mean fluorescence intensity were calculated for all the markers. RESULTS APL showed significantly higher expression of CD64, CD2, and CD13, whereas more leukemic cells were positive for CD11b, CD11c, CD15, CD36, and HLA-DR in NPM1+ AMLs. Radar plots featured CD2 expression, a lack of a monocytic component, lack of expression of HLA-DR and CD15, and a lack of a prominent CD11c+ population as recurring characteristics of APL. The presence of blasts with low SSC, presence of at least some monocytes, some expression of HLA-DR and/or CD15, and a prominent CD11c population were recurrent characteristics of NPM1+ AMLs. Radar plot analysis could confidently separate all hypergranular APL cases from any NPM1+ AML and in 90% of cases between variant APL and blastic NPM1+ AML. CONCLUSION Radar plots can potentially add to differential diagnostics as they exhibit characteristic patterns distinguishing APL and different types of NPM1+ AMLs.
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Affiliation(s)
- Monali Gupta
- Immunophenotyping Laboratory, Viapath Analytics LLP, Department of Hematology, Kings College Hospital, London, UK.,Department of Pathobiology and Laboratory Medicine, Division of Hematopathology, University Health Network, Toronto, Ontario, Canada
| | - Katayoon Jafari
- Department of Pathobiology and Laboratory Medicine, Division of Hematopathology, University Health Network, Toronto, Ontario, Canada.,Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Amr Rajab
- Department of Pathobiology and Laboratory Medicine, Division of Hematopathology, University Health Network, Toronto, Ontario, Canada.,Medical-Scientific Department, Lifelabs Medical Laboratory Services, Toronto, Ontario, Canada
| | - Cuihong Wei
- Department of Pathobiology and Laboratory Medicine, Division of Hematopathology, University Health Network, Toronto, Ontario, Canada.,Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Joanna Mazur
- Department of Humanization of Medicine and Sexology, Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland.,Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
| | - Anne Tierens
- Department of Pathobiology and Laboratory Medicine, Division of Hematopathology, University Health Network, Toronto, Ontario, Canada
| | - Elizabeth Hyjek
- Department of Pathobiology and Laboratory Medicine, Division of Hematopathology, University Health Network, Toronto, Ontario, Canada.,Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Rumina Musani
- Department of Pathobiology and Laboratory Medicine, Division of Hematopathology, University Health Network, Toronto, Ontario, Canada
| | - Anna Porwit
- Department of Pathobiology and Laboratory Medicine, Division of Hematopathology, University Health Network, Toronto, Ontario, Canada.,Faculty of Medicine, Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden
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van Dongen JJM, O'Gorman MRG, Orfao A. EuroFlow and its activities: Introduction to the special EuroFlow issue of The Journal of Immunological Methods. J Immunol Methods 2019; 475:112704. [PMID: 31758969 DOI: 10.1016/j.jim.2019.112704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Jacques J M van Dongen
- Department of Immunohematology and Blood Transfusion (IHB), Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - Maurice R G O'Gorman
- Departments of Pathology and Pediatrics, The Keck School of Medicine, U. of Southern California, Children's Hospital of Los Angeles Los Angeles, CA, USA
| | - Alberto Orfao
- Cancer Research Centre (IBMCC-CASIC/USAL), Department of Medicine, Cytometry Service (NUCLEUS) and Institute for Biomedical Research of Salamanca (IBSAL), University of Salamanca, Salamanca (Spain) and CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
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10
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Lacombe F, Lechevalier N, Vial JP, Béné MC. An R-Derived FlowSOM Process to Analyze Unsupervised Clustering of Normal and Malignant Human Bone Marrow Classical Flow Cytometry Data. Cytometry A 2019; 95:1191-1197. [PMID: 31577391 DOI: 10.1002/cyto.a.23897] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 01/14/2023]
Abstract
Multiparameter flow cytometry (MFC) is a powerful and versatile tool to accurately analyze cell subsets, notably to explore normal and pathological hematopoiesis. Yet, mostly supervised subjective strategies are used to identify cell subsets in this complex tissue. In the past few years, the implementation of mass cytometry and the big data generated have led to a blossoming of new software solutions. Their application to classical MFC in hematology is however still seldom reported. Here, we show how one of these new tools, the FlowSOM R solution, can be applied, together with the Kaluza® software, to a new delineation of hematopoietic subsets in normal human bone marrow (BM). We thus combined the unsupervised discrimination of cell subsets provided by FlowSOM and their expert-driven node-by-node assignment to known or new hematopoietic subsets. We also show how this new tool could modify the MFC exploration of hematological malignancies both at diagnosis (Dg) and follow-up (FU). This can be achieved by direct comparison of merged listmodes of reference normal BM, Dg, and FU samples of a representative acute myeloblastic case tested with the same immunophenotyping panel. This provides an immediate unsupervised evaluation of minimal residual disease. © 2019 International Society for Advancement of Cytometry.
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Affiliation(s)
- Francis Lacombe
- Flow cytometry department, Hematology Laboratory, Bordeaux University Hospital, Pessac, France
| | - Nicolas Lechevalier
- Flow cytometry department, Hematology Laboratory, Bordeaux University Hospital, Pessac, France
| | - Jean Philippe Vial
- Flow cytometry department, Hematology Laboratory, Bordeaux University Hospital, Pessac, France
| | - Marie C Béné
- Hematology Biology, Nantes University Hospital, CRCINA, Nantes, France
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Wang SA. Issue Highlights-September 2018 (94B5). CYTOMETRY PART B-CLINICAL CYTOMETRY 2019; 94:560-564. [PMID: 30240159 DOI: 10.1002/cyto.b.21740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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12
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Lanza F. Issue Highlight - July 2018. CYTOMETRY PART B-CLINICAL CYTOMETRY 2019; 94:557-560. [PMID: 30134072 DOI: 10.1002/cyto.b.21644] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Francesco Lanza
- Hematology Institute Romagna Stem Cell Transplantation Programme, Ravenna 48121, Italy
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13
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Muyldermans A, Florin L, Devos H, Cauwelier B, Emmerechts J. Diagnostic utility of the lymphoid screening tube supplemented with CD34 for Ogata score calculation in patients with peripheral cytopenia. ACTA ACUST UNITED AC 2018; 24:166-172. [PMID: 30334700 DOI: 10.1080/10245332.2018.1535536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The diagnosis of myelodysplastic syndrome (MDS) is not always straightforward in the absence of objective markers such as ringed sideroblasts, an excess of blasts or clonal cytogenetic abnormalities. Moreover, the lack of specificity of morphological dysplasia makes the differentiation between MDS and other causes of peripheral cytopenia difficult. The WHO 2016 classification of MDS recognizes multiparameter flow cytometry (MFC) as an adjuvant tool for MDS diagnosis. An easily applicable MFC protocol based on CD34 and CD45 is proposed by Ogata et al. Furthermore, in the diagnostic workup of patients with peripheral cytopenia, the integration of MFC by means of a Lymphoid Screening Tube (LST) is recommended by the EuroFlow™ consortium. The aim of this study was to investigate whether the LST, supplemented with CD34, can be used to calculate the Ogata score, thereby obviating the need to run different flow cytometric tubes. METHODS Bone marrow samples from 108 patients with peripheral cytopenia were analyzed (MDS n = 32; non-MDS n = 76). The LST used in the present study was based on the tube designed by the EuroFlow™ consortium, but with addition of CD34 and without TCRγδ. RESULTS Rather low sensitivities of 55% in low-grade MDS patients and 80% in high-grade MDS patients were observed. However, a high specificity of 92% was found in the non-MDS group. CONCLUSION Besides screening for clonal lymphocytes, plasma cells and blasts, an LST supplemented with CD34 allows the calculation of the Ogata score as an adjuvant tool in the diagnostic workup of cytopenic patients suspected of MDS.
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Affiliation(s)
- Astrid Muyldermans
- a Department of Laboratory Hematology , AZ Sint-Jan Hospital , Bruges , Belgium
| | - Lisa Florin
- a Department of Laboratory Hematology , AZ Sint-Jan Hospital , Bruges , Belgium
| | - Helena Devos
- a Department of Laboratory Hematology , AZ Sint-Jan Hospital , Bruges , Belgium
| | - Barbara Cauwelier
- a Department of Laboratory Hematology , AZ Sint-Jan Hospital , Bruges , Belgium
| | - Jan Emmerechts
- a Department of Laboratory Hematology , AZ Sint-Jan Hospital , Bruges , Belgium
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14
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Revising flow cytometric mini-panel for diagnosing low-grade myelodysplastic syndromes: Introducing a parameter quantifying CD33 expression on CD34+ cells. Leuk Res 2018; 71:75-81. [DOI: 10.1016/j.leukres.2018.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/05/2018] [Accepted: 07/09/2018] [Indexed: 11/18/2022]
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15
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Lorand-Metze I, Longhini AL, Oliveira-Duarte G, Correia RP, Santos-Silva MC, Yamamoto M, Sandes AF, Oliveira AF, Souto EX, Ikoma MRV, Pereira-Cunha FG, Beltrame M, Metze K. Normal variation of bone marrow B-cell precursors according to age - reference ranges for studies in myelodysplastic syndromes in Brazil. CYTOMETRY PART B-CLINICAL CYTOMETRY 2017; 94:644-650. [DOI: 10.1002/cyto.b.21604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 11/28/2017] [Accepted: 11/29/2017] [Indexed: 12/21/2022]
Affiliation(s)
- I. Lorand-Metze
- Hematology - Hemotherapy Center, University of Campinas, Campinas; São Paulo Brazil
| | - A. L. Longhini
- Hematology - Hemotherapy Center, University of Campinas, Campinas; São Paulo Brazil
| | - G. Oliveira-Duarte
- Hematology - Hemotherapy Center, University of Campinas, Campinas; São Paulo Brazil
| | - R. P. Correia
- Laboratory of Hematology, Hospital Albert Einstein; São Paulo Brazil
| | - M. C. Santos-Silva
- Laboratory of Experimental Oncology; Federal University of Santa Catarina; Florianópolis Brazil
| | - M. Yamamoto
- Department of Hematology; Federal University of São Paulo; São Paulo Brazil
| | - A. F. Sandes
- Laboratory of Hematology; Laboratórios Fleury; São Paulo Brazil
| | - A. F. Oliveira
- Laboratory of Hematology; Childrens' Cancer Hospital, Barretos Cancer Center; Barretos Brazil
| | - E. X. Souto
- Laboratory of Hematology; DASA; São Paulo Brazil
| | - M. R. V. Ikoma
- Laboratory of Cytometry; Hospital Amaral Carvalho; Jaú, São Paulo Brazil
| | | | - M. Beltrame
- Department of Hematology; Federal University of Paraná; Curitiba Brazil
| | - K. Metze
- Department of Pathology; University of Campinas; Campinas Brazil
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16
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17
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Correia RP, Rajab A, Bento LC, Alexandre AM, Vaz AC, Schimidell D, Pedro EC, Perin FS, Nozawa ST, Barroso RS, Bacal NS. A ten-color tube with dried antibody reagents for the screening of hematological malignancies. Int J Lab Hematol 2017; 40:136-143. [PMID: 28980400 DOI: 10.1111/ijlh.12753] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 08/31/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The workflow in clinical flow cytometry laboratories must constantly be reviewed to develop technical procedures that improve quality and productivity and reduce costs. Using the Beckman Coulter dry coating technology, we customized a ten-color tube with dried antibody reagents, designated the Duraclone screening tube (DST), for screening hematological malignancies. Here, we compared the applicability, clinical and numerical equivalence, and cost and time required for the technical procedures between the liquid reagents and the DST. METHODS The DST contains CD4 + Kappa-FITC, CD8 + Lambda-PE, CD3 + CD14-ECD, CD33-PE-Cy5.5, CD20 + CD56-PE-Cy7, CD34-APC, CD19-APC-AlexaFluor700, CD10-APC-AlexaFluor750, CD5-Pacific Blue, and CD45-Krome Orange. We evaluated 20 bone marrow samples, 13 peripheral blood samples, 6 lymph node biopsy samples, 5 fine-needle aspirate samples, 5 cerebrospinal fluid samples, and 1 pleural fluid sample. RESULTS The DST was useful for more than 60% of our samples. It was able to enumerate the majority of the populations in all types of samples with a statistically acceptable correlation with the liquid reagents. The use of the DST translated into significant time and cost savings of 15.8% and 12.3%, respectively, compared with the use of the liquid reagent. The cost was reduced by $14.36 per sample. CONCLUSIONS The DST is an efficient solution for screening hematological malignancies with improved quality, productivity, standardization, and sustainability. These improvements could benefit patients by providing faster diagnoses using a higher quality and lower cost reagent.
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Affiliation(s)
- R P Correia
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | - A Rajab
- Hematology Department, LifeLabs Medical Laboratory Services, Toronto, ON, Canada
| | - L C Bento
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | - A M Alexandre
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | - A C Vaz
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | - D Schimidell
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | - E C Pedro
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | - F S Perin
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | - S T Nozawa
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | - R S Barroso
- Clinical Pathology Laboratory, Division of Hematology and Flow Cytometry, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | - N S Bacal
- Centro de Hematologia de São Paulo, São Paulo, SP, Brazil
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18
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Basso-Ricci L, Scala S, Milani R, Migliavacca M, Rovelli A, Bernardo ME, Ciceri F, Aiuti A, Biasco L. Multiparametric Whole Blood Dissection: A one-shot comprehensive picture of the human hematopoietic system. Cytometry A 2017; 91:952-965. [PMID: 28609016 PMCID: PMC5697613 DOI: 10.1002/cyto.a.23148] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 04/11/2017] [Accepted: 05/17/2017] [Indexed: 12/12/2022]
Abstract
Human hematopoiesis is a complex and dynamic system where morphologically and functionally diverse mature cell types are generated and maintained throughout life by bone marrow (BM) Hematopoietic Stem/Progenitor Cells (HSPC). Congenital and acquired hematopoietic disorders are often diagnosed through the detection of aberrant frequency or composition of hematopoietic cell populations. We here describe a novel protocol, called “Whole Blood Dissection” (WBD), capable of analyzing in a single test‐tube, hematopoietic progenitors and all major mature cell lineages composing either BM or peripheral blood (PB) through a multiparametric flow‐cytometry analysis. WBD allows unambiguously identifying in the same tube up to 23 different blood cell types including HSPC subtypes and all the major myeloid and lymphoid lineage compartments at different stages of maturation, through a combination of 17 surface and 1 viability cell markers. We assessed the efficacy of WBD by analyzing BM and PB samples from adult (n = 8) and pediatric (n = 9) healthy donors highlighting age‐related shift in cell composition. We also tested the capability of WBD on detecting aberrant hematopoietic cell composition in clinical samples of patients with primary immunodeficiency or leukemia unveiling expected and novel hematopoietic unbalances. Overall, WBD allows unambiguously identifying >99% of the cell subpopulations composing a blood sample in a reproducible, standardized, cost‐, and time‐efficient manner. This tool has a wide range of potential pre‐clinical and clinical applications going from the characterization of hematopoietic disorders to the monitoring of hematopoietic reconstitution in patients after transplant or gene therapy. © 2017 The Authors. Cytometry Part A Published by Wiley Periodicals, Inc. on behalf of ISAC.
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Affiliation(s)
- Luca Basso-Ricci
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), San Raffaele Scientific Institute, Milan, 20132, Italy
| | - Serena Scala
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), San Raffaele Scientific Institute, Milan, 20132, Italy
| | - Raffaella Milani
- Cytometry Laboratory, San Raffaele Scientific Institute, Milan, Italy
| | - Maddalena Migliavacca
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), San Raffaele Scientific Institute, Milan, 20132, Italy.,San Raffaele Scientific Institute, Pediatric Immunohematology and Bone Marrow Transplantation Unit, Milan, Italy
| | - Attilio Rovelli
- BMT Unit, Pediatric Department, Milano-Bicocca University, MBBM Foundation, Monza, Italy
| | - Maria Ester Bernardo
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), San Raffaele Scientific Institute, Milan, 20132, Italy.,San Raffaele Scientific Institute, Pediatric Immunohematology and Bone Marrow Transplantation Unit, Milan, Italy
| | - Fabio Ciceri
- San Raffaele Scientific Institute, Hematology and Bone Marrow Transplantation Unit, Milan, Italy
| | - Alessandro Aiuti
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), San Raffaele Scientific Institute, Milan, 20132, Italy.,San Raffaele Scientific Institute, Pediatric Immunohematology and Bone Marrow Transplantation Unit, Milan, Italy.,Vita Salute San Raffaele University, Milan, Italy
| | - Luca Biasco
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), San Raffaele Scientific Institute, Milan, 20132, Italy
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Ebo DG. Highlights - June 2017. CYTOMETRY PART B-CLINICAL CYTOMETRY 2017; 92:247-248. [PMID: 28556550 DOI: 10.1002/cyto.b.21534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Didier G Ebo
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp (Belgium)
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20
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Rajab A, Axler O, Leung J, Wozniak M, Porwit A. Ten-color 15-antibody flow cytometry panel for immunophenotyping of lymphocyte population. Int J Lab Hematol 2017; 39 Suppl 1:76-85. [DOI: 10.1111/ijlh.12678] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 03/08/2017] [Indexed: 01/13/2023]
Affiliation(s)
- A. Rajab
- Hematology Department; LifeLabs; Toronto ON Canada
| | - O. Axler
- Klinisk patologi, Labmedicin; Medicinsk Service, Region Skåne; Lunds Universitetsjukhus; Lund Sweden
| | - J. Leung
- Flow Cytometry Laboratory; Laboratory Medicine Program; University Health Network; Toronto ON Canada
| | - M. Wozniak
- Hematology Department; LifeLabs; Toronto ON Canada
| | - A. Porwit
- Division for Oncology and Pathology; Department of Clinical Sciences Lund; Faculty of Medicine; Lund University; Lund Sweden
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21
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Williams-Voorbeijtel D, Sanchez F, Roth CG. Aligning the flow cytometric evaluation with the diagnostic need: an evidence-based approach. J Clin Pathol 2017; 70:740-744. [DOI: 10.1136/jclinpath-2016-204316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 01/19/2017] [Accepted: 01/20/2017] [Indexed: 01/31/2023]
Abstract
AimsElimination of non-value added testing without compromising high-quality clinical care is an important mandate for laboratories in a value-based reimbursement system. The goal of this study was to determine the optimal combination of flow cytometric markers for a screening approach that balances efficiency and accuracy.MethodsAn audit over 9 months of flow cytometric testing was performed, including rereview of all dot plots from positive cases.ResultsOf the 807 cases in which leukaemia/lymphoma testing was performed, 23 were non-diagnostic and 189 represented bronchoalveolar lavage specimens. Of the remaining 595 cases, 137 (23%) were positive for an abnormal haematolymphoid population. Review of the positive cases identified minimum requirements for a screening tube as well as analysis strategies to overcome the diagnostic pitfalls noted. It is estimated that 38% fewer antibodies would be used in a screening approach, representing an opportunity for significant cost savings.ConclusionsWe provide a framework for developing an evidence-based screening combination for cost-effective characterisation of haematolymphoid malignancies, promoting adoption of ‘just-in-time’ testing systems that tailor the evaluation to the diagnostic need.
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22
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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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23
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Jamin C, Le Lann L, Alvarez-Errico D, Barbarroja N, Cantaert T, Ducreux J, Dufour AM, Gerl V, Kniesch K, Neves E, Trombetta E, Alarcón-Riquelme M, Marañon C, Pers JO. Multi-center harmonization of flow cytometers in the context of the European “PRECISESADS” project. Autoimmun Rev 2016; 15:1038-1045. [DOI: 10.1016/j.autrev.2016.07.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 07/12/2016] [Indexed: 01/10/2023]
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24
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Stacchini A, Demurtas A, Aliberti S, Barreca A, Novero D, Pacchioni D. Single-Tube Flow Cytometry Assay for the Detection of Mature Lymphoid Neoplasms in Paucicellular Samples. Acta Cytol 2016; 60:385-394. [PMID: 27597993 DOI: 10.1159/000448799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 08/02/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Flow cytometry (FC) has become a useful support for cytomorphologic evaluation (CM) of fine-needle aspirates (FNA) and serous cavity effusions (SCE) in cases of suspected non-Hodgkin lymphoma (NHL). FC results may be hampered by the scarce viability and low cellularity of the specimens. STUDY DESIGN We developed a single-tube FC assay (STA) that included 10 antibodies cocktailed in 8-color labeling, a cell viability dye, and a logical gating strategy to detect NHL in hypocellular samples. The results were correlated with CM and confirmed by histologic or molecular data when available. RESULTS Using the STA, we detected B-type NHL in 31 out of 103 hypocellular samples (81 FNA and 22 SCE). Of these, 8 were not confirmed by CM and 2 were considered to be only suspicious. The FC-negative samples had a final diagnosis of benign/reactive process (42/72), carcinoma (27/72), or Hodgkin lymphoma (3/72). CONCLUSIONS The STA approach allowed obtainment of maximum immunophenotyping data in specimens containing a low number of cells and a large amount of debris. The information obtained by STA can help cytomorphologists not only to recognize but also to exclude malignant lymphomas.
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Mahdi T, Rajab A, Padmore R, Porwit A. Characteristics of Lymphoproliferative Disorders with More Than One Aberrant Cell Population as Detected by 10-Color Flow Cytometry. CYTOMETRY PART B-CLINICAL CYTOMETRY 2016; 94:230-238. [DOI: 10.1002/cyto.b.21402] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 06/06/2016] [Accepted: 07/14/2016] [Indexed: 01/28/2023]
Affiliation(s)
- Talal Mahdi
- Department of Pathology and Laboratory Medicine; the Ottawa Hospital and Eastern Ontario Regional Laboratory Association and University of Ottawa; ON Canada
- Department of Laboratory Hematology, Flow Cytometry Laboratory, Laboratory Medicine Program; University Health Network; Toronto ON Canada
| | - Amr Rajab
- Department of Laboratory Hematology, Flow Cytometry Laboratory, Laboratory Medicine Program; University Health Network; Toronto ON Canada
| | - Ruth Padmore
- Department of Pathology and Laboratory Medicine; the Ottawa Hospital and Eastern Ontario Regional Laboratory Association and University of Ottawa; ON Canada
| | - Anna Porwit
- Department of Laboratory Hematology, Flow Cytometry Laboratory, Laboratory Medicine Program; University Health Network; Toronto ON Canada
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Jacob MC, Souvignet A, Pont J, Solly F, Mondet J, Kesr S, Pernollet M, Dumestre-Perard C, Campos L, Cesbron JY. One tube with eight antibodies for 14-part bone marrow leukocyte differential using flow cytometry. CYTOMETRY PART B-CLINICAL CYTOMETRY 2016; 92:299-309. [PMID: 26990701 DOI: 10.1002/cyto.b.21369] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 02/16/2016] [Accepted: 03/10/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Bone marrow analysis by flow cytometry is part of the routine diagnosis of hematological disorders in medical laboratories. Differential leukocyte count and identification of abnormal cell subsets is currently performed through morphological examination on bone marrow smears by skilled cytologists. In this work, we propose a single 8-color tube for providing equivalent information, using flow cytometry. METHODS 99 bone marrow samples were classified into 2 groups, (i) 51 samples, obtained from either healthy donors (n = 4) or patients with various diseases at diagnosis or during remission that did not present a hematological malignancy (n = 47), and (ii) 48 pathological samples with quantitative and/or qualitative abnormalities. A panel of eight antibodies-CD3-FITC/CD10-PE/CD38-PerCP-Cy5.5/CD19-PECy7/CD36-APC/CD16-APC-H7/CD34-BV421/CD45-V500-was tested to identify the main cell subsets at different stages of maturation using a FACSCanto-II analyzer. RESULTS We first proposed a strategy of sequential gating leading to the identification of 14 leukocyte subsets, that is, erythroblasts, monocytes, B-lymphoid cells from hematogones to plasma-cells (5 subsets), T- and NK-cells, polymorphonuclear cells (neutrophils, eosinophils, and basophils), myeloblasts and other immature granular cells. This approach was validated by comparing flow cytometry and microscopic morphological examination, both in cases of normal and abnormal samples. Interestingly, cell identification, and numeration by flow cytometry was easy to perform and highly reproducible. CONCLUSION A very simple, rapid, and reproducible flow cytometric approach, using a combination of eight antibodies allows determination of the cellular composition of bone marrow with high precision. © 2016 International Clinical Cytometry Society.
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Affiliation(s)
- Marie-Christine Jacob
- Université Grenoble-Alpes, Grenoble, 38000, France.,CNRS UMR 5309 and INSERM, U1209, Institut Albert Bonniot, Grenoble, 38706, France.,Department of Immunology CHU Grenoble, La Tronche, F-38700, France
| | - Alice Souvignet
- Department of Immunology CHU Grenoble, La Tronche, F-38700, France
| | - Julie Pont
- Department of Hematology, CHU Grenoble, La Tronche, F-38700, France
| | - Françoise Solly
- Department of Hematology, CHU Saint Etienne, Saint Priest en Jarez, F-42270, France
| | - Julie Mondet
- Department of Hematology, CHU Grenoble, La Tronche, F-38700, France.,Therex, TIMC-IMAG, CNRS Université Joseph Fourier, La Tronche, F-38700, France
| | - Sanae Kesr
- Université Paris Diderot-CHU Saint Etienne, Saint Priest en Jarez, F-42270, France
| | | | | | - Lydia Campos
- Department of Hematology, CHU Saint Etienne, Saint Priest en Jarez, F-42270, France
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27
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Porwit A, Rajab A. Flow cytometry immunophenotyping in integrated diagnostics of patients with newly diagnosed cytopenia: one tube 10-color 14-antibody screening panel and 3-tube extensive panel for detection of MDS-related features. Int J Lab Hematol 2015; 37 Suppl 1:133-43. [DOI: 10.1111/ijlh.12368] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 03/17/2015] [Indexed: 12/01/2022]
Affiliation(s)
- A. Porwit
- Department of Pathobiology and Laboratory Medicine; University of Toronto; University Health Network; Toronto ON Canada
| | - A. Rajab
- Department of Pathobiology and Laboratory Medicine; University of Toronto; University Health Network; Toronto ON Canada
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