Fernández Eduardo, Vásquez Carlos, Urrutia Luis, Jara Casandra, Veas Carlos, Chandía Mauricio
Facultad de Medicina, Universidad de Concepción, Concepción, Chile.
Departamento de Pediatría, Facultad de Medicina, Universidad de Concepción, Concepción, Chile.
Rev Med Chil. 2024 Mar;152(3):376-381. doi: 10.4067/s0034-98872024000300376.
The diagnosis of blast cell presence in cerebrospinal fluid (CSF) in acute leukemias (AL) is made using techniques such as flow cytometry (FCM) and conventional cytology (CC). This study aims to evaluate CSF blast cell presence frequency in LA using both techniques (CC and FCM) in our center.
We analyzed three hundred and eight CSF samples belonging to 175 patients, 57% male, with a median age of 46 years (1-70 years) were analyzed. Diagnoses were acute B lymphoblastic leukemia (B-ALL, 84%), acute T lymphoblastic leukemia (T-ALL 5%), acute myeloblastic leukemia (AML, 11%). The immunophenotype was performed with an 8-color panel adapted to the diagnosis.
The proportion of non-assessable CSF samples in LA was higher for CC (46%) than FCM (4%) (p<0.05). Overall, infiltration was found in 78/308 samples by FCM (25.3%) and in 8/77 by CC (10.4%) (p<0.0001). Seventy of 259 samples were positive in B-ALL (27%) and 6/34 in AML (17%). There were no CC+ cases in AML or T-ALL. The samples that were FCM+/CC+ had more significant infiltration (59.5%) than CMF+/CC-ones (30%) (p<0.0001).
CMF detects more than twice as many CSF blast-positive cases in LA as CC and is, therefore, suitable for routine use along with CC.
急性白血病(AL)患者脑脊液(CSF)中原始细胞的诊断采用流式细胞术(FCM)和传统细胞学(CC)等技术。本研究旨在使用我们中心的这两种技术(CC和FCM)评估LA中脑脊液原始细胞的存在频率。
我们分析了属于175例患者的308份脑脊液样本,其中57%为男性,中位年龄为46岁(1 - 70岁)。诊断为急性B淋巴细胞白血病(B - ALL,84%)、急性T淋巴细胞白血病(T - ALL 5%)、急性髓细胞白血病(AML,11%)。采用适用于诊断的8色面板进行免疫表型分析。
LA中CC不可评估的脑脊液样本比例(46%)高于FCM(4%)(p<0.05)。总体而言,FCM在78/308份样本中发现浸润(25.3%),CC在8/77份样本中发现浸润(10.4%)(p<0.0001)。259份B - ALL样本中有70份呈阳性(27%),AML的34份样本中有6份呈阳性(17%)。AML或T - ALL中没有CC +病例。FCM + /CC +的样本比CMF + /CC -的样本浸润更显著(59.5%对30%)(p<0.0001)。
CMF检测到的LA中脑脊液原始细胞阳性病例数是CC的两倍多,因此适用于与CC一起常规使用。