Immunophenotyping and immunoglobulin heavy chain gene rearrangement analysis in cerebrospinal fluid of pediatric patients with acute lymphoblastic leukemia

Central nervous system (CNS) involvement by lymphoid neoplasms is a relatively infrequent event that demands accurate identification. The purpose of this article is to review studies comparing diagnostic accuracy of flow cytometry (FCM) and cytomorphology (CM) for meningeal involvement from lymphoid neoplasms. Primary publications from the last 26 years were identified searching MedLine, Scopus, and Web of Science and systematically scanning bibliographies of identified articles. Only studies reporting complete results were included. We assessed study quality using the QUADAS‐2 tool. For each study, we extracted informations regarding study population, technical details about sample preparation, data analysis, and results. Twenty‐seven studies were included. A great heterogeneity regarding study populations and analytical procedures was observed among studies. Percentages of samples giving a positive result with both FCM and CM range from 0.3% to 42.9% among studies, whereas double negative samples go from 0% to 96.3%. Samples with positive FCM but negative CM are reported by 89% (24/27) of the studies with rates ranging from 3.5% to 61.5% of total specimens. On the contrary, samples with positive CM and negative FCM are found in 48% (13/27) of the studies with percentages ranging from 0.5% to 10%. Despite all the differences observed among studies, almost all of them state that employing flow cytometry along with conventional cytology increases the number of positive CSF samples for lymphoma involvement, although a few cases remain in whom only morphology can correctly identify malignant cells. Diagn. Cytopathol. 2016;44:841–856. © 2016 Wiley Periodicals, Inc.

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“…A total of 41 studies comparing flow cytometry and cytology in CSF samples from patients with lymphoid neoplasia were identified .…”

Section: Resultsmentioning

confidence: 99%

Accuracy of flow cytometry and cytomorphology for the diagnosis of meningeal involvement in lymphoid neoplasms: A systematic review

Canovi

Campioli

2016

Diagnostic Cytopathology

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“…This can be done by ana lysis of immunoglobulin rearrangement at multiple- [37,38] or single-cell level [39]. Some study groups, however, have seen no clear advantage over conventional cytology [26].…”

Section: Molecular Markersmentioning

confidence: 99%

Diagnosis and individualized therapy of neoplastic meningitis

Strik

Prömmel²

2010

Expert Review of Anticancer Therapy

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Neoplastic meningitis is a diffuse dissemination of tumor cells into the cerebrospinal fluid (CSF) and/or leptomeninges. It occurs in approximately 5-10% of malignant diseases, most often in breast cancer, lung cancer, melanoma or B-cell lymphoma. Symptoms of neoplastic meningitis are head or back pain, cranial nerve palsies, diffuse radicular symptoms or psychiatric disturbances. MRI shows nodular contrast enhancement lining CSF spaces. Positive CSF cytology requires optimal sampling and processing. Treatment must be individually shaped: the CSF dissemination may be treated with intrathecal chemotherapy with methotrexate or cytarabinoside (Ara-C). Liposomal Ara-C is distributed over the entire CSF space even after lumbar application and maintains cytotoxic levels for at least 2 weeks. Radiotherapy should be applied only to symptomatic solid spinal manifestations or fast progressing cranial nerve palsies. Systemic chemotherapy is needed to control solid manifestations or, in the case of substances entering the CSF, to support intrathecal chemotherapy.

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“…Cerebrospinal fluid (CSF) analysis by flow cytometry (FCM) and cytomorphology (CM) is currently requested to explore central nervous system (CNS) involvement by hematologic malignancy, both at diagnosis and during follow-up [1][2][3][4][5][6][7][8][9][10][11]. To date, the two methods have been mostly studied on CSF from newly diagnosed cases, i.e., those optimally evaluable samples not liable to intrathecal treatment-related damage [2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…To date, the two methods have been mostly studied on CSF from newly diagnosed cases, i.e., those optimally evaluable samples not liable to intrathecal treatment-related damage [2][3][4][5][6][7][8][9]. In this setting, immunophenotype analysis is well known to guarantee the highest accuracy, morphologic exam still retaining an additional diagnostic value according to some authors [2,3,5-8, 11,12].…”

Section: Introductionmentioning

confidence: 99%

Flow cytometry and cytomorphology evaluation of hematologic malignancy in cerebrospinal fluids: comparison with retrospective clinical outcome

et al. 2011

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Immunophenotyping and immunoglobulin heavy chain gene rearrangement analysis in cerebrospinal fluid of pediatric patients with acute lymphoblastic leukemia

Cited by 25 publications

References 29 publications

Accuracy of flow cytometry and cytomorphology for the diagnosis of meningeal involvement in lymphoid neoplasms: A systematic review

Accuracy of flow cytometry and cytomorphology for the diagnosis of meningeal involvement in lymphoid neoplasms: A systematic review

Diagnosis and individualized therapy of neoplastic meningitis

Flow cytometry and cytomorphology evaluation of hematologic malignancy in cerebrospinal fluids: comparison with retrospective clinical outcome

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