Hematology, Department of BioMedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
Blood Transfusion Center, Legnano General Hospital, Legnano, Italy.
Cytometry B Clin Cytom. 2021 May;100(3):269-281. doi: 10.1002/cyto.b.21981. Epub 2020 Dec 25.
Central nervous system (CNS) involvement is a serious but often underdiagnosed complication of hematological malignancies. Currently, the gold standard to detect CNS involvement is conventional cytology (CC) whose sensitivity though is lower than 50%. Multiparametric flow cytometry (MFC) demonstrated a superior sensitivity over CC, particularly when low levels of CNS infiltrating cells are present. Although prospective studies are few, a positive finding by MFC appears to anticipate an adverse outcome even if CC shows no infiltration. However, the use of MFC to diagnose CNS involvement presents some pitfalls, due to the typical hypocellularity of cerebrospinal fluids (CSF), and low cell vitality. Furthermore, the threshold to be used for defining the MFC positivity is not universally defined. In this paper, a working group of the European Society for Clinical Cell Analysis-ESCCA-and the Italian Society for Clinical Cell Analysis-ISCCA-will discuss the critical aspects of CSF processing, highlighting difficulties in storage and processing of samples, interpretation and reporting of data.
中枢神经系统（CNS）受累是血液系统恶性肿瘤的一种严重但常被低估的并发症。目前，检测 CNS 受累的金标准是常规细胞学（CC），但其敏感性低于 50%。多参数流式细胞术（MFC）显示出优于 CC 的敏感性，尤其是在存在低水平的 CNS 浸润细胞时。尽管前瞻性研究较少，但 MFC 的阳性发现似乎预示着不良预后，即使 CC 没有浸润。然而，由于脑脊液（CSF）的典型低细胞性和低细胞活力，MFC 用于诊断 CNS 受累存在一些缺陷。此外，用于定义 MFC 阳性的阈值尚未普遍定义。在本文中，欧洲临床细胞分析学会（ESCCA）和意大利临床细胞分析学会（ISCCA）的一个工作组将讨论 CSF 处理的关键方面，强调样本存储和处理、数据解释和报告方面的困难。
