Flow cytometry for detection of central nervous system disease in acute myeloid leukemia

Sorigué, Marc; Juncà, Jordi; Sancho, Juan‐Manuel; Esteban, Dani; Navarro, José-Tomás; Vives, Susana; Feliú, Evarist; Ribera, Josep‐Marǐa

doi:10.3109/10428194.2014.996752

Cited by 6 publications

(7 citation statements)

References 8 publications

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“…Flow cytometry was used successfully in the detection of CNS involvement in ALL and can successfully distinct between low risk and high risk patients (220). This technique is very useful in detecting minimal residual disease thus proving to be a powerful tool in the monitorization of leukemic patients, by being able to detect 1 abnormal cell from 10,000 events (221)(222)(223), however much attention must be paid to sampling, storage and processing (224,225). First the CSF must be collected in tubes that do not contain anti-coagulants (such as EDTA, heparin treated tubes).…”

Section: Cns Leukemia-diagnostic Toolsmentioning

confidence: 99%

A narrative review of central nervous system involvement in acute leukemias

Deak¹,

Gorcea-Andronic²,

Sas³

et al. 2021

Ann Transl Med

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Acute leukemias (both myeloid and lymphoblastic) are a group of diseases for which each year more successful therapies are implemented. However, in a subset of cases the overall survival (OS) is still exceptionally low due to the infiltration of leukemic cells in the central nervous system (CNS) and the subsequent formation of brain tumors. The CNS involvement is more common in acute lymphocytic leukemia (ALL), than in adult acute myeloid leukemia (AML), although the rates for the second case might be underestimated. The main reasons for CNS invasion are related to the expression of specific adhesion molecules (VLA-4, ICAM-1, VCAM, L-selectin, PECAM-1, CD18, LFA-1, CD58, CD44, CXCL12) by a subpopulation of leukemic cells, called "sticky cells" which have the ability to interact and adhere to endothelial cells. Moreover, the microenvironment becomes hypoxic and together with secretion of VEGF-A by ALL or AML cells the permeability of vasculature in the bone marrow increases, coupled with the disruption of blood brain barrier. There is a single subpopulation of leukemia cells, called leukemia stem cells (LSCs) that is able to resist in the new microenvironment due to its high adaptability. The LCSs enter into the arachnoid, migrate, and intensively proliferate in cerebrospinal fluid (CSF) and consequently infiltrate perivascular spaces and brain parenchyma. Moreover, the CNS is an immune privileged site that also protects leukemic cells from chemotherapy. CD56/NCAM is the most important surface molecule often overexpressed by leukemic stem cells that offers them the ability to infiltrate in the CNS. Although

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Section: Cns Leukemia-diagnostic Toolsmentioning

confidence: 99%

A narrative review of central nervous system involvement in acute leukemias

Deak¹,

Gorcea-Andronic²,

Sas³

et al. 2021

Ann Transl Med

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“…19 In the study by Sorigué et al, although disease-free survival (DFS) and OS differed on comparisons of FCM+/CC− and FCM−/CC− patients with AML, statistical significance was not observed. 20 Therefore, it seems that the prognostic significance detected by FCM is more obvious in patients with ALL than in patients with AML according to the literature.…”

Section: Discussionmentioning

confidence: 98%

Flow cytometric analysis of cerebrospinal fluid in adult patients with acute lymphoblastic leukemia during follow‐up

Gong

Lin

Wang

et al. 2018

European J of Haematology

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“…After haematopoietic stem cell transplantation, which is a common therapy for suitable AML patients, the presence of blasts in the CSF does not correlate with survival but may be associated with a higher rate of relapse 17 . Taken together, it is clear that at the current time, the natural history and clinical significance of CNS involvement in AML remains an open question 18 . Risk factors for CNS involvement by AML include: (1) high levels of pretreatment serum lactate dehydrogenase; (2) high peripheral blood white blood cell count (WBC); (3) inversion of chromosome inv (16)/ translocation t(16;16); (4) chromosome 11 abnormalities; (5) myelomonocytic/monoblastic immunophenotype; and (6) young age 12 …”

Section: Discussionmentioning

confidence: 99%

“…17 Taken together, it is clear that at the current time, the natural history and clinical significance of CNS involvement in AML remains an open question. 18 relapse is suspected. 19 This guideline also recommends CSF morphologic examination of AML patients receiving intrathecal chemotherapy.…”

Section: Study Selectionmentioning

confidence: 99%

Technological features of blast identification in the cerebrospinal fluid: A systematic review of flow cytometry and laboratory haematology methods

Frater

Shirai

Brestoff

2022

Int J Lab Hematology

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Background: Involvement of the central nervous system (CNS) by acute leukemias (ALs) has important implications for risk stratification and disease outcome. The clinical laboratory plays an essential role in assessment of cerebrospinal fluid (CSF) specimens from patients with ALs at initial diagnosis, at the end of treatment, and when CNS involvement is clinically suspected. The two challenges for the laboratory are 1) to accurately provide a cell count of the CSF and 2) to successfully distinguish blasts from other cell types. These tasks are classically performed using manual techniques, which suffer from suboptimal turnaround time, imprecision, and inconsistent interoperator performance. Technological innovations in flow cytometry and hematology analyzer technology have provided useful complements and/or alternatives to conventional manual techniques.Aims: We performed a PRISMA-compliant systematic review to address the medical literature regarding the development and current state of the art of CSF blast identification using flow cytometry and laboratory hematology technologies. Materials and Methods:We searched the peer reviewed medical literature using MEDLINE (PubMed interface), Web of Science, and Embase using the keywords "CSF or cerebrospinal" AND "blasts(s)".Results: 108 articles were suitable for inclusion in our systematic review. These articles covered 1) clinical rationale for CSF blast identification; 2) morphology-based CSF blast identification; 3) the role of flow cytometry; 4) use of hematology analyzers for CSF blast identification; and 5) quality issues. 9 /L, which is much lower than the original machine count and platelet transfusion was warranted.Discussion: 1) Clinical laboratory testing plays a central role in risk stratification and clinical management of patients with acute leukemias, most clearly in pediatric ALs;2) studies focused on other patient populations, including adults and patients with AML are less prevalent in the literature; 3) improvements in instrumentation may provide better performance for the classification of CSF specimens. Conclusion:Current challenges include: 1) more precisely characterizing the natural history of AL involvement of the CNS, 2) improvements in automated cell count technology of low cellularity specimens, 3) defining the role of flow MRD testing of CSF specimens and 4) improved recognition of specimen quality by clinicians and laboratory personnel.

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Flow cytometry for detection of central nervous system disease in acute myeloid leukemia

Cited by 6 publications

References 8 publications

A narrative review of central nervous system involvement in acute leukemias

A narrative review of central nervous system involvement in acute leukemias

Flow cytometric analysis of cerebrospinal fluid in adult patients with acute lymphoblastic leukemia during follow‐up

Technological features of blast identification in the cerebrospinal fluid: A systematic review of flow cytometry and laboratory haematology methods

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