Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA.
Am J Clin Pathol. 2020 May 5;153(6):790-798. doi: 10.1093/ajcp/aqaa007.
To improve diagnostic accuracy in differentiating hematogones from leukemic blasts in cases of precursor B-lymphoblastic leukemia/lymphoma (B-ALL), particularly those that are posttreatment or after bone marrow transplant, and to provide an algorithmic approach to this diagnostic challenge.
A seven-color antibody panel including CD10, CD19, CD45, CD38, CD34, CD58, and CD81 was generated to assess the feasibility of a single tube panel and provide an algorithmic approach to distinguish hematogones from B-ALL. Fifty-three cases were analyzed, and results were correlated with histology and ancillary studies.
There was a significant difference in mean fluorescent intensity (MFI) for CD81 and CD58 when comparing hematogones and B-ALL populations (P < .001). B-ALL cases had a mean (SD) MFI of 24.6 (27.5; range, 2-125) for CD81 and 135.6 (72.6; range, 48-328) for CD58. Hematogones cases had a mean (SD) MFI of 70.2 (19.2; range, 42-123) for CD81 and 38.8 (9.4; range, 23-58) for CD58.
The flow cytometry panel with the above markers and utilization of the proposed algorithmic approach provide differentiation of hematogones from B-ALL. This includes rare cases of hematogones and B-ALL overlap where additional ancillary studies are necessary.
提高鉴别前体 B 淋巴细胞白血病/淋巴瘤（B-ALL）中造血细胞与白血病细胞的诊断准确性，尤其是治疗后或骨髓移植后的病例，并提供一种解决这一诊断难题的算法。
采用包括 CD10、CD19、CD45、CD38、CD34、CD58 和 CD81 七种抗体的组合，评估单管面板的可行性，并提供一种算法来区分造血细胞和 B-ALL。分析了 53 例病例，并将结果与组织学和辅助研究相关联。
在比较造血细胞和 B-ALL 群体时，CD81 和 CD58 的平均荧光强度（MFI）有显著差异（P<0.001）。B-ALL 病例的 CD81 和 CD58 的平均（SD）MFI 分别为 24.6（27.5；范围，2-125）和 135.6（72.6；范围，48-328）。造血细胞病例的 CD81 和 CD58 的平均（SD）MFI 分别为 70.2（19.2；范围，42-123）和 38.8（9.4；范围，23-58）。
该流式细胞术组合标记物和提出的算法能够区分造血细胞和 B-ALL，包括罕见的造血细胞和 B-ALL 重叠病例，需要进一步进行辅助研究。
