The utility of peripheral blood smear review for identifying specimens for flow cytometric immunophenotyping

Abstract

Laboratory professionals are in an ideal situation to identify CBC and peripheral blood smear findings that raise the possibility of a hematolymphoid neoplasm, and based on this information make recommendations for additional studies, such as flow cytometric immunophenotyping. In some circumstances a definitive diagnosis can be established from the combined peripheral blood morphologic and immunophenotypic findings obviating the need for bone marrow evaluation, such as for chronic lympho-

Acute Myeloid Leukemia in a Three-Year-Old Girl Mimicking Chronic Myeloid Leukemia in Blast Crisis, Challenge in Diagnosis and Treatment in Limited-Resourced Health Care Facility: A Case Report

“…Peripheral blood smear may assist in displaying the spectrum of cells at different stages of maturation and neutrophilic toxic changes [12]. There were two suspicions from this patient's peripheral blood smear.…”

“…CBC with a differential count and peripheral blood smear should be considered as the tools to help guide the diagnosis of suspected AML or leukemia cases in children [1,12]. In our hospital, CBC revealed leukocytosis with white blood cell 42.45x103/µL with severe anemia (hemoglobin 5.7 g/dL) and severe thrombocytopenia (platelet count 11 x103/µL).…”

“…Retrospective analyses show an association of monocytic AML subtypes (FAB cell counts ≤ 50,000/mcL (≤ 50 × 109/L) and even in some with higher white blood cell counts, immature granulocytes may not be seen [16]. Bone marrow aspiration is still warranted to accurately diagnose childhood leukemia [1,12].…”

Validation of Hematology Rapid Reporting System for Complete Blood Cell Count with Differential

“…Thus, it becomes easier and less time-and labor-intensive to review these blood samples using manual techniques and to provide more accurate results. Therefore, for screening hematologic malignancies, microscopic examination of blood films can be conjunctively used with hematology analyzers in clinical laboratories to con rm ags for blast detection [6,7].…”

CD8 Antigen Expression in Chronic Lymphocytic Leukemia: Does it Have any Relevant Meaning?

“…Namely, although international guidelines for flow cytometry diagnosis of hematological diseases recommend the use of a lymphocyte screening tube containing markers for B‐lymphocytes (CD19, CD20, kappa, lambda), T‐lymphocytes (CD3, CD4, CD5, CD8, CD38, TCRγδ) and NK‐lymphocytes (CD56), for reasons directly related to financial costs and time savings, some centers around the world, especially those located in countries of low income, do not start the immunophenotypical study using the lymphocyte screening tube. Rather, they resort to the old fashioned, but yet effective and cheap, combination of an automatic complete blood count plus peripheral blood smear review with the aim to decide the initial antibody panel to be used . In this scenario, based on the well‐known much higher prevalence of mature B‐cell neoplasms (over 90% worldwide) when compared to mature T and NK‐cell neoplasms , the presence of lymphocytosis rationally points to the initial use of a panel with specificity for the diagnosis of a mature B‐cell lineage disease and which, usually, does not include monoclonal antibodies with specificity for the CD8 antigen.…”