A comparison of flow cytometry, bone marrow biopsy, and bone marrow aspirates in the detection of lymphoid infiltration in B cell disorders

Abstract

Aims: To evaluate the diagnostic value of bone marrow aspirates, trephine biopsies (BMB), and flow cytometry (FC) in the assessment of bone marrow infiltration in chronic lymphoid disorders. Methods: Investigations were carried out in 110 diagnostic and follow up specimens from B cell disorders, namely: chronic lymphocytic leukaemia (CLL; 65), non-Hodgkin's lymphoma (NHL; 39), and hairy cell leukaemia (HCL; 6). A selected panel of monoclonal antibodies was used both for FC and immunohistochemistry. Results: In CLL there was agreement between the three investigations in 71% of samples and in 88% when only FC and BMB were compared. In nine of 65 samples, FC and BMB were positive, although the aspirate was reported as negative. Four BMB negative samples had minimal residual disease (MRD) detected by FC, whereas two samples were positive both on BMB and aspirate but showed no evidence of disease on FC. In NHL, there was agreement between the three investigations in 22 of 39 cases, and in 27 of 39 cases there was agreement between FC and BMB. In eight of 39 NHL cases, FC was negative but the BMB was either positive (five) or uncertain (three), whereas in three of 39, FC was positive but BMB was either negative (one) or uncertain (two). In three of five uncertain BMB, no clonal population was detected by the polymerase chain reaction, whereas in the remaining two cases the nodular aggregates disappeared on further sectioning. Conclusions: Both BMB and FC are better than bone marrow aspirates for the detection of infiltration in B cell disorders. FC might be slightly more sensitive than BMB to detect MRD in CLL, whereas BMB may be slightly better than FC in NHL.

ZAP-70 expression, as detected by immunohistochemistry on bone marrow biopsies from early-phase CLL patients, is a strong adverse prognostic factor

“…In our experience, less than 3% of cases of CLL had absent or limited and not diagnostic lymphoid infiltration (data not shown), in contrast with up to 10% negative BM biopsies reported in CLL by Sah et al 28 Moreover, the use of BM biopsies in our study allowed us to evaluate retrospectively a large series of CLL patients with adequate follow-up (median 58 months).…”

Diagnóstico de imunofenótipos de síndromes linfoproliferativas crônicas por citometria de fluxo na Fundação HEMOPA

“…No entanto, em função da similaridade da morfologia muitas vezes observada nesse material, sua classificação e, consequentemente, a escolha do tratamento são bastante dificultados, exigindo a confirmação diagnóstica por meio da biópsia de outros órgãos, como baço e linfonodos (1,10,14) .…”

“…A biópsia de medula óssea (MO) ou mesmo de outros órgãos linfoides para o diagnóstico de síndromes linfoproliferativas crônicas, todavia, além de demoradas, invasivas, que necessitam de técnicas complementares de diagnóstico, como a imuno-histoquímica, exigem a presença de profissionais treinados e altamente qualificados para a diferenciação dessas neoplasias (4,14) . Diversos autores têm sugerido a utilização da imunofenotipagem por citometria de fluxo aliada à citologia convencional como método rápido e não invasivo de diagnós-tico alternativo para síndromes linfoproliferativas (2-7, 9, 11, 14, 15) .…”

A unique bone marrow lymphoma patient presenting with an isolated mass: A case report

“…For a number of cases with a limited number of lymphoma cells involving bone marrow, FCM may assist with diagnosis (18,19). However, there may be different results between BMA/BMB and FCM (20,21).…”

“…The bone marrow karyotype was 46, XY [20]. Flow cytometric (FCM) analysis revealed that CD45 + CD19 + cells, which were potentially abnormal B lymphocytes, expressed human leukocyte antigen-antigen d related, CD5, CD11c, CD20, CD22, CD38, limited FCM-7 antigen, no κ-or λ-polyclone, and accounted for 0.5% of nuclear cells.…”