COMPARISON OF BONE MARROW ASPIRATE FLOW CYTOMETRY AND TREPHINE IMMUNOHISTOCHEMISTRY IN STAGING OF PATIENTS WITH LYMPHOMA.
(Abstract release date: 05/19/16)
EHA Library. Shah G. 06/09/16; 132508; E959
Dr. Gulnaz Shah
Contributions
Contributions
Abstract
Abstract: E959
Type: Eposter Presentation
Background
Accurate staging of lymphoma is essential for guiding management and predicting outcome. Bone marrow biopsies are performed as part of routine staging for patients with lymphoma and immunohistochemistry on the trephine biopsy is considered the gold standard. Multiparameter Flow Cytometry (MFC) is increasingly sensitive at detecting small clonal B-cell populations and abnormal T-cell phenotypes on bone marrow aspirate samples but it is not clear that this adds additional clinically relevant information.
Aims
To compare results of MFC on bone marrow aspirates with immunohistochemistry on trephine biopsies for patients with T- and B-cell lymphomas to assess whether MFC is of additional clinical utility.
Methods
Results of lymphoma staging marrows received by the King’s College Hospital Haematological Malignancy Diagnostic Centre between June 2014 and June 2015 were retrospectively reviewed. All aspirate samples had MFC performed using the following antibodies; CD19, CD5, CD4, CD8, CD2, CD20, CD23, CD10, CD79b, CD49d, CD38, FMC7, kappa and lambda.
Results
117 patient samples were received. The lymphoma diagnoses included diffuse large B-cell lymphoma (DLBCL; n=63), follicular lymphoma (FL; n=29), primary central nervous system lymphoma (n=9), marginal zone lymphoma (n=6), high grade transformation of low grade lymphoma (n=4), mantle cell lymphoma (n=2), post-transplant lymphoproliferative disorder (n=2) and T-cell lymphoma (n=2). The concordance rate between trephine histology and MFC was 86.3% (n=101). Both were negative in 89 cases (76.1%) and positive in 12 cases (10.3%). Three cases (2.6%) were detected by MFC alone but not apparent on the trephine histology. The diagnoses in these cases included primary central nervous system lymphoma (3% CD5-/CD10- clonal B-cells; n=1), mantle cell lymphoma (2% clonal B-cells; n=1) and DLBCL (4% CD5-/CD10- clonal B-cells; n=1). In these three cases the clinical management was not altered by knowledge of the MFC results. Ten cases (8.5%) were histologically positive but negative by MFC. The diagnoses in these cases were FL (n=4), DLBCL (n=2), T-cell lymphoma (n=1) and FL transformed to DLBCL (n = 3). There were three cases (2.6%) with suboptimal trephines. One of which was a case of DLBCL in which MFC was positive (5% CD5-/CD10- clonal B cells).
Conclusion
As reported in other series, the concordance between multiparameter flow cytometry and the trephine biopsy is high. Rarely, MFC can detect low-level bone marrow involvement not detected by immunohistochemistry. However, these results are unlikely to alter clinical management. In resource stretched health care systems, MFC on lymphoma staging marrows may not be justified.
Session topic: E-poster
Keyword(s): Flow cytometry, Lymphoma
Type: Eposter Presentation
Background
Accurate staging of lymphoma is essential for guiding management and predicting outcome. Bone marrow biopsies are performed as part of routine staging for patients with lymphoma and immunohistochemistry on the trephine biopsy is considered the gold standard. Multiparameter Flow Cytometry (MFC) is increasingly sensitive at detecting small clonal B-cell populations and abnormal T-cell phenotypes on bone marrow aspirate samples but it is not clear that this adds additional clinically relevant information.
Aims
To compare results of MFC on bone marrow aspirates with immunohistochemistry on trephine biopsies for patients with T- and B-cell lymphomas to assess whether MFC is of additional clinical utility.
Methods
Results of lymphoma staging marrows received by the King’s College Hospital Haematological Malignancy Diagnostic Centre between June 2014 and June 2015 were retrospectively reviewed. All aspirate samples had MFC performed using the following antibodies; CD19, CD5, CD4, CD8, CD2, CD20, CD23, CD10, CD79b, CD49d, CD38, FMC7, kappa and lambda.
Results
117 patient samples were received. The lymphoma diagnoses included diffuse large B-cell lymphoma (DLBCL; n=63), follicular lymphoma (FL; n=29), primary central nervous system lymphoma (n=9), marginal zone lymphoma (n=6), high grade transformation of low grade lymphoma (n=4), mantle cell lymphoma (n=2), post-transplant lymphoproliferative disorder (n=2) and T-cell lymphoma (n=2). The concordance rate between trephine histology and MFC was 86.3% (n=101). Both were negative in 89 cases (76.1%) and positive in 12 cases (10.3%). Three cases (2.6%) were detected by MFC alone but not apparent on the trephine histology. The diagnoses in these cases included primary central nervous system lymphoma (3% CD5-/CD10- clonal B-cells; n=1), mantle cell lymphoma (2% clonal B-cells; n=1) and DLBCL (4% CD5-/CD10- clonal B-cells; n=1). In these three cases the clinical management was not altered by knowledge of the MFC results. Ten cases (8.5%) were histologically positive but negative by MFC. The diagnoses in these cases were FL (n=4), DLBCL (n=2), T-cell lymphoma (n=1) and FL transformed to DLBCL (n = 3). There were three cases (2.6%) with suboptimal trephines. One of which was a case of DLBCL in which MFC was positive (5% CD5-/CD10- clonal B cells).
Conclusion
As reported in other series, the concordance between multiparameter flow cytometry and the trephine biopsy is high. Rarely, MFC can detect low-level bone marrow involvement not detected by immunohistochemistry. However, these results are unlikely to alter clinical management. In resource stretched health care systems, MFC on lymphoma staging marrows may not be justified.
Session topic: E-poster
Keyword(s): Flow cytometry, Lymphoma
Abstract: E959
Type: Eposter Presentation
Background
Accurate staging of lymphoma is essential for guiding management and predicting outcome. Bone marrow biopsies are performed as part of routine staging for patients with lymphoma and immunohistochemistry on the trephine biopsy is considered the gold standard. Multiparameter Flow Cytometry (MFC) is increasingly sensitive at detecting small clonal B-cell populations and abnormal T-cell phenotypes on bone marrow aspirate samples but it is not clear that this adds additional clinically relevant information.
Aims
To compare results of MFC on bone marrow aspirates with immunohistochemistry on trephine biopsies for patients with T- and B-cell lymphomas to assess whether MFC is of additional clinical utility.
Methods
Results of lymphoma staging marrows received by the King’s College Hospital Haematological Malignancy Diagnostic Centre between June 2014 and June 2015 were retrospectively reviewed. All aspirate samples had MFC performed using the following antibodies; CD19, CD5, CD4, CD8, CD2, CD20, CD23, CD10, CD79b, CD49d, CD38, FMC7, kappa and lambda.
Results
117 patient samples were received. The lymphoma diagnoses included diffuse large B-cell lymphoma (DLBCL; n=63), follicular lymphoma (FL; n=29), primary central nervous system lymphoma (n=9), marginal zone lymphoma (n=6), high grade transformation of low grade lymphoma (n=4), mantle cell lymphoma (n=2), post-transplant lymphoproliferative disorder (n=2) and T-cell lymphoma (n=2). The concordance rate between trephine histology and MFC was 86.3% (n=101). Both were negative in 89 cases (76.1%) and positive in 12 cases (10.3%). Three cases (2.6%) were detected by MFC alone but not apparent on the trephine histology. The diagnoses in these cases included primary central nervous system lymphoma (3% CD5-/CD10- clonal B-cells; n=1), mantle cell lymphoma (2% clonal B-cells; n=1) and DLBCL (4% CD5-/CD10- clonal B-cells; n=1). In these three cases the clinical management was not altered by knowledge of the MFC results. Ten cases (8.5%) were histologically positive but negative by MFC. The diagnoses in these cases were FL (n=4), DLBCL (n=2), T-cell lymphoma (n=1) and FL transformed to DLBCL (n = 3). There were three cases (2.6%) with suboptimal trephines. One of which was a case of DLBCL in which MFC was positive (5% CD5-/CD10- clonal B cells).
Conclusion
As reported in other series, the concordance between multiparameter flow cytometry and the trephine biopsy is high. Rarely, MFC can detect low-level bone marrow involvement not detected by immunohistochemistry. However, these results are unlikely to alter clinical management. In resource stretched health care systems, MFC on lymphoma staging marrows may not be justified.
Session topic: E-poster
Keyword(s): Flow cytometry, Lymphoma
Type: Eposter Presentation
Background
Accurate staging of lymphoma is essential for guiding management and predicting outcome. Bone marrow biopsies are performed as part of routine staging for patients with lymphoma and immunohistochemistry on the trephine biopsy is considered the gold standard. Multiparameter Flow Cytometry (MFC) is increasingly sensitive at detecting small clonal B-cell populations and abnormal T-cell phenotypes on bone marrow aspirate samples but it is not clear that this adds additional clinically relevant information.
Aims
To compare results of MFC on bone marrow aspirates with immunohistochemistry on trephine biopsies for patients with T- and B-cell lymphomas to assess whether MFC is of additional clinical utility.
Methods
Results of lymphoma staging marrows received by the King’s College Hospital Haematological Malignancy Diagnostic Centre between June 2014 and June 2015 were retrospectively reviewed. All aspirate samples had MFC performed using the following antibodies; CD19, CD5, CD4, CD8, CD2, CD20, CD23, CD10, CD79b, CD49d, CD38, FMC7, kappa and lambda.
Results
117 patient samples were received. The lymphoma diagnoses included diffuse large B-cell lymphoma (DLBCL; n=63), follicular lymphoma (FL; n=29), primary central nervous system lymphoma (n=9), marginal zone lymphoma (n=6), high grade transformation of low grade lymphoma (n=4), mantle cell lymphoma (n=2), post-transplant lymphoproliferative disorder (n=2) and T-cell lymphoma (n=2). The concordance rate between trephine histology and MFC was 86.3% (n=101). Both were negative in 89 cases (76.1%) and positive in 12 cases (10.3%). Three cases (2.6%) were detected by MFC alone but not apparent on the trephine histology. The diagnoses in these cases included primary central nervous system lymphoma (3% CD5-/CD10- clonal B-cells; n=1), mantle cell lymphoma (2% clonal B-cells; n=1) and DLBCL (4% CD5-/CD10- clonal B-cells; n=1). In these three cases the clinical management was not altered by knowledge of the MFC results. Ten cases (8.5%) were histologically positive but negative by MFC. The diagnoses in these cases were FL (n=4), DLBCL (n=2), T-cell lymphoma (n=1) and FL transformed to DLBCL (n = 3). There were three cases (2.6%) with suboptimal trephines. One of which was a case of DLBCL in which MFC was positive (5% CD5-/CD10- clonal B cells).
Conclusion
As reported in other series, the concordance between multiparameter flow cytometry and the trephine biopsy is high. Rarely, MFC can detect low-level bone marrow involvement not detected by immunohistochemistry. However, these results are unlikely to alter clinical management. In resource stretched health care systems, MFC on lymphoma staging marrows may not be justified.
Session topic: E-poster
Keyword(s): Flow cytometry, Lymphoma
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