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Güell N, Mozas P, Jimenez-Rueda A, Miljkovic M, Juncà J, Sorigue M. Methodological and conceptual challenges to the flow cytometric classification of leukemic lymphoproliferative disorders. Crit Rev Clin Lab Sci 2023; 60:83-100. [PMID: 36066070 DOI: 10.1080/10408363.2022.2114418] [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: 01/18/2023]
Abstract
The diagnosis of leukemic B-cell lymphoproliferative disorders (B-LPDs) is made by integrating clinical, cytological, cytometric, cytogenetic, and molecular data. This leaves room for differences and inconsistencies between experts. In this study, we examine methodological and conceptual aspects of the flow cytometric classification of leukemic B-LPDs that could explain them. Among methodological aspects, we discuss (1) the different statistical tests used to select and evaluate markers, (2) how these markers are analyzed, (3) how scores are interpreted, (4) different degrees to which diagnostic information is used, and (5) and the impact of differences in study populations. Among conceptual aspects, we discuss (1) challenges to integrating different biological data points, (2) the under examination of the costs of misclassification (false positives and false negatives), and finally, (3) we delve into the impact of the lack of a true diagnostic gold standard and the indirect evidence suggesting poor reproducibility in the diagnosis of leukemic B-LPDs. We then outline current harmonization efforts and our personal approach. We conclude that numerous flow cytometry scores and diagnostic systems are now available; however, as long as the considerations discussed remain unaddressed, external reproducibility and interobserver agreement will not be achieved, and the field will not be able to move forward if a true gold standard is not found.
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Affiliation(s)
- Nadia Güell
- Hematology Laboratory, Unitat de citometria ICO-Badalona (CITICOB), Hospital Germans Trias i Pujol, IJC, LUMN, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Pablo Mozas
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Alba Jimenez-Rueda
- Hematology Laboratory, Unitat de citometria ICO-Badalona (CITICOB), Hospital Germans Trias i Pujol, IJC, LUMN, Universitat Autònoma de Barcelona, Badalona, Spain.,Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | | | - Jordi Juncà
- Hematology Laboratory, Unitat de citometria ICO-Badalona (CITICOB), Hospital Germans Trias i Pujol, IJC, LUMN, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Marc Sorigue
- Hematology Laboratory, Unitat de citometria ICO-Badalona (CITICOB), Hospital Germans Trias i Pujol, IJC, LUMN, Universitat Autònoma de Barcelona, Badalona, Spain
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Güell N, Junca J, Raya M, Vergara S, Sorigue M. Overlap between CD23 and CD200 in leukemic lymphoproliferative disorders. Int J Lab Hematol 2022; 44:e149-e152. [PMID: 35000272 DOI: 10.1111/ijlh.13791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/27/2021] [Accepted: 12/23/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Nadia Güell
- Hematology Laboratory, Unitat de citometria ICO-Badalona (CITICOB), Hospital Germans Trias i Pujol, Functional Cytomics-IJC, LUMN, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Jordi Junca
- Hematology Laboratory, Unitat de citometria ICO-Badalona (CITICOB), Hospital Germans Trias i Pujol, Functional Cytomics-IJC, LUMN, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Minerva Raya
- Hematology Laboratory, Unitat de citometria ICO-Badalona (CITICOB), Hospital Germans Trias i Pujol, Functional Cytomics-IJC, LUMN, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Sara Vergara
- Hematology Laboratory, Unitat de citometria ICO-Badalona (CITICOB), Hospital Germans Trias i Pujol, Functional Cytomics-IJC, LUMN, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Marc Sorigue
- Hematology Laboratory, Unitat de citometria ICO-Badalona (CITICOB), Hospital Germans Trias i Pujol, Functional Cytomics-IJC, LUMN, Universitat Autònoma de Barcelona, Badalona, Spain
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Soliman DS, Al-Kuwari E, Al-Abdulla R, Chandra P, Nashwan A, Hilmi FA. Biologic characterization of atypical chronic lymphocytic leukaemia. Int J Lab Hematol 2021; 44:e49-e51. [PMID: 34224207 DOI: 10.1111/ijlh.13645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/10/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Dina S Soliman
- Department of Laboratory Medicine and Pathology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.,Weill Cornell Medical College-Qatar (WCMC-Q), Doha, Qatar.,Department of Clinical Pathology, National Cancer Institute, Cairo, Egypt
| | - Einas Al-Kuwari
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Rajaa Al-Abdulla
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Prem Chandra
- Medical Research Center, Academic Health Systems, Hamad Medical Corporation, Doha, Qatar
| | - Abdulqader Nashwan
- Nursing Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Feryal A Hilmi
- Department of Laboratory Medicine and Pathology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
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Sorigue M, Junca J, Zamora L. New biological insights into atypical chronic lymphocytic leukemia. Int J Lab Hematol 2021; 44:e8-e9. [PMID: 34218524 DOI: 10.1111/ijlh.13647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 04/22/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Marc Sorigue
- Hematology Laboratory, Unitat de Citometria de Flux de l'ICO-Badalona (CITICOB), Functional Cytomics- IJC,, LUMN, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Jordi Junca
- Hematology Laboratory, Unitat de Citometria de Flux de l'ICO-Badalona (CITICOB), Functional Cytomics- IJC,, LUMN, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Lurdes Zamora
- Hematology Laboratory, Unitat de Citometria de Flux de l'ICO-Badalona (CITICOB), Functional Cytomics- IJC,, LUMN, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
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