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Sholl LM, Longtine J, Kuo FC. Molecular Analysis of Genetic Markers for Non-Hodgkin Lymphomas. CURRENT PROTOCOLS IN HUMAN GENETICS 2017; 93:10.14.1-10.14.29. [PMID: 28384399 DOI: 10.1002/cphg.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Molecular analysis complements the clinical and histopathologic tools used to diagnose and subclassify hematologic malignancies. The presence of clonal antigen-receptor gene rearrangements can help to confirm the diagnosis of a B or T cell lymphoma and can serve as a fingerprint of that neoplasm to be used in identifying concurrent disease at disparate sites or recurrence at future time points. Certain lymphoid malignancies harbor a characteristic chromosomal translocation, a finding that may have significant implications for an individual's prognosis or response to therapy. The polymerase chain reaction (PCR) is typically used to detect antigen-receptor gene rearrangements as well as specific translocations that can be supplemented by fluorescence in situ hybridization (FISH) and karyotype analysis. © 2017 by John Wiley & Sons, Inc.
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Affiliation(s)
| | | | - Frank C Kuo
- Brigham and Women's Hospital, Boston, Massachusetts
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2
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Dezorella N, Kay S, Baron S, Shapiro M, Porat Z, Deutsch V, Herishanu Y, Katz BZ. Measurement of lymphocyte aggregation by flow cytometry-physiological implications in chronic lymphocytic leukemia. CYTOMETRY PART B-CLINICAL CYTOMETRY 2015; 90:257-66. [DOI: 10.1002/cyto.b.21263] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 05/26/2015] [Accepted: 06/02/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Nili Dezorella
- The Department of Hematology; Tel Aviv Sourasky Medical Center; Tel-Aviv Israel 64239
- Sackler Faculty of Medicine; Tel Aviv University; Tel-Aviv Israel
| | - Sigi Kay
- The Department of Hematology; Tel Aviv Sourasky Medical Center; Tel-Aviv Israel 64239
| | - Shoshana Baron
- The Department of Hematology; Tel Aviv Sourasky Medical Center; Tel-Aviv Israel 64239
| | - Mika Shapiro
- The Department of Hematology; Tel Aviv Sourasky Medical Center; Tel-Aviv Israel 64239
| | - Ziv Porat
- The Biological Services Department; Life Sciences Faculty, Weizmann Institute of Science; Rehovot Israel
| | - Varda Deutsch
- The Department of Hematology; Tel Aviv Sourasky Medical Center; Tel-Aviv Israel 64239
| | - Yair Herishanu
- The Department of Hematology; Tel Aviv Sourasky Medical Center; Tel-Aviv Israel 64239
- Sackler Faculty of Medicine; Tel Aviv University; Tel-Aviv Israel
| | - Ben-Zion Katz
- The Department of Hematology; Tel Aviv Sourasky Medical Center; Tel-Aviv Israel 64239
- Sackler Faculty of Medicine; Tel Aviv University; Tel-Aviv Israel
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Validation of ZAP-70 methylation and its relative significance in predicting outcome in chronic lymphocytic leukemia. Blood 2014; 124:42-8. [PMID: 24868078 DOI: 10.1182/blood-2014-02-555722] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
ZAP-70 methylation 223 nucleotides downstream of transcription start (CpG+223) predicts outcome in chronic lymphocytic leukemia (CLL), but its impact relative to CD38 and ZAP-70 expression or immunoglobulin heavy chain variable region (IGHV) status is uncertain. Additionally, standardizing ZAP-70 expression analysis has been unsuccessful. CpG+223 methylation was quantitatively determined in 295 untreated CLL cases using MassARRAY. Impact on clinical outcome vs CD38 and ZAP-70 expression and IGHV status was evaluated. Cases with low methylation (<20%) had significantly shortened time to first treatment (TT) and overall survival (OS) (P < .0001). For TT, low methylation defined a large subset of ZAP-70 protein-negative cases with significantly shortened TT (median, 8.0 vs 3.9 years for high vs low methylation; hazard ratio [HR] = 0.43; 95% confidence interval [CI], 0.25-0.74). Conversely, 16 ZAP-70 protein-positive cases with high methylation had poor outcome (median, 1.1 vs 2.3 years for high vs low methylation; HR = 1.62; 95% CI, 0.87-3.03). For OS, ZAP-70 methylation was the strongest risk factor; CD38 and ZAP-70 expression or IGHV status did not significantly improve OS prediction. A pyrosequencing assay was established that reproduced the MassARRAY data (κ coefficient > 0.90). Thus, ZAP-70 CpG+223 methylation represents a superior biomarker for TT and OS that can be feasibly measured, supporting its use in risk-stratifying CLL.
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Semanaj V, Pecani A, Dedej T, Barbullushi A, Ylli Z, Curaj T, Pulluqi P, Caja T, Perolla A, Ivanaj A, Xhumari P, Sulcebe G. The Diagnostic Value of Flow Cytometry Imunophenotyping in an Albanian Patient Population with a Preliminary Clinical Diagnosis of Chronic Lymphocytic Leukemia. Open Access Maced J Med Sci 2014. [DOI: 10.3889/oamjms.2014.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: Based on the flow cytometry multiparametric immunophenotyping methodology we studied some useful cell marker criteria needed for the practical differentiation of the chronic lymphocytic leukemia from other chronic limphoproliferative diseases with a leukemic component.Materials and Methods: The applied methodology is a four color flow cytometry multiparametric immunophenotyping technique using EDTA blood samples taken from 84 consecutive patients diagnosed with CLL through a preliminary clinical and white blood cell examination. The following fluorescent stained monoclonal antibodies were used: CD3, CD4, CD5, CD8, CD11c, CD19, CD20, CD23, CD25, FMC7 and kappa/lambda light chains.Results: From the 84 individuals tested, 2 out of them (2.4%) resulted with a abnormal T-cell population while 82 (97.6%) showed a pathological B cell line. 58 (69.1%) patients resulted with typical CLL markers (CD19+CD5+CD23+) while 5 (5.9%) of them presented a non typical chronic lymphocytic leukemia profile (CD19+CD5+CD23-). 19 (22.6%) out of patients displayed an abnormal CD19+CD5- B cell population. A statistically significant correlation was found between the clinical stage of CLL and the positivity for the CD38 marker (p=0.04).Conclusion: Flow cytometry immunophenotyping is a fundamental examination for the final diagnosis of chronic lymphocytic leukemia. The expression of CD38+ in CLL patients stands for a more advanced clinical stage.
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Adams RLC, Cheung C, Banh R, Saal R, Cross D, Gill D, Self M, Klein K, Mollee P. Prognostic value of ZAP-70 expression in chronic lymphocytic leukemia as assessed by quantitative polymerase chain reaction and flow cytometry. CYTOMETRY PART B-CLINICAL CYTOMETRY 2013. [DOI: 10.1002/cyto.b.21138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Rebecca L. C. Adams
- Hematology Department; Pathology Queensland, and Princess Alexandra Hospital; Brisbane Australia
- School of Medicine; University of Queensland; Brisbane Australia
- Hematology Department; QML Pathology; Brisbane Australia
| | - Catherine Cheung
- Hematology Department; Pathology Queensland, and Princess Alexandra Hospital; Brisbane Australia
- University of Queensland Diamantina Institute; Brisbane Australia
| | - Raymond Banh
- Hematology Department; Pathology Queensland, and Princess Alexandra Hospital; Brisbane Australia
- Division of Cancer Services; Mater Hospital; Brisbane Australia
| | - Russell Saal
- Hematology Department; Pathology Queensland, and Princess Alexandra Hospital; Brisbane Australia
| | - Donna Cross
- Hematology Department; Pathology Queensland, and Princess Alexandra Hospital; Brisbane Australia
| | - Devinder Gill
- Hematology Department; Pathology Queensland, and Princess Alexandra Hospital; Brisbane Australia
- School of Medicine; University of Queensland; Brisbane Australia
| | - Marlene Self
- Hematology Department; Pathology Queensland, and Princess Alexandra Hospital; Brisbane Australia
| | - Kerenaftali Klein
- Queensland Clinical Trials and Biostatistics Centre, School of Population Health; University of Queensland; Brisbane Australia
| | - Peter Mollee
- Hematology Department; Pathology Queensland, and Princess Alexandra Hospital; Brisbane Australia
- School of Medicine; University of Queensland; Brisbane Australia
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Degheidy HA, Venzon DJ, Farooqui MZ, Abbasi F, Arthur DC, Wilson WH, Wiestner A, Stetler-Stevenson MA, Marti GE. Combined normal donor and CLL: Single tube ZAP-70 analysis. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2012; 82:67-77. [PMID: 22031337 PMCID: PMC3407416 DOI: 10.1002/cyto.b.20622] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 07/14/2011] [Accepted: 08/19/2011] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Zeta-chain-associated protein kinase 70 (ZAP-70) has been identified as an independent prognostic marker in chronic lymphocytic leukemia (CLL). Based on our previous studies, we have developed a combined one-tube technology with multiple internal controls to optimize ZAP-70 assessment. METHODS Forty-eight untreated CLL cases were examined for ZAP-70 expression using a modified 7-color one-tube assay. Normal donor (ND) whole blood is stained with CD3 APC-Cy7 and CD19 APC. In a second tube, patient whole blood is stained with CD5 PE-Cy7, CD19 PerCP-Cy5.5, and CD20 eFluor450. After surface staining and fixation, these two tubes are combined. After saponin permeabilization, the cells were stained with two anti-ZAP-70 clones (1E7.2/AF488 and SBZAP/PE). The results obtained from this modified tube were compared with those obtained concurrently using the non-mixed single sample tubes. Five different methods of ZAP-70 expression analysis were evaluated: percentage positive cells using ND T-cells as a reference; the internal patient T-cell/clone ratio; ND T-cell/clone ratio; clone/ND B-cell ratio; and modified Z-index. RESULT Overall, the combined patient and ND mix tube performed better than the non-mixed single sample tube. The strongest correlations between ZAP-70 expression and immunoglobulin heavy chain variable (IGHV) mutational status were seen with percentage positive ND T-cell, ND T-cell/clone ratio, and clone/ND B-cell ratio for both 1E7.2 and SBZAP clone (P < 0.0001). CONCLUSION The modified one tube method combining the ND and patient sample provides highly reliable results that correlate with the IGHV mutational status. This method should be considered as part of the next step in standardization of the ZAP-70 assay in CLL.
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Affiliation(s)
- Heba A. Degheidy
- Center for Biologics Evaluation and Research, FDA, Bethesda, MD, USA
| | | | | | - Fatima Abbasi
- Center for Biologics Evaluation and Research, FDA, Bethesda, MD, USA
| | | | | | | | | | - Gerald E. Marti
- Center for Biologics Evaluation and Research, FDA, Bethesda, MD, USA
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Degheidy HA, Venzon DJ, Farooqui MZ, Abbasi F, Arthur DC, Wilson WH, Wiestner A, Stetler-Stevenson MA, Marti GE. Methodological comparison of two anti-ZAP-70 antibodies. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2011; 80:300-8. [PMID: 21472849 PMCID: PMC3461319 DOI: 10.1002/cyto.b.20591] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 12/17/2010] [Accepted: 01/24/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND ZAP-70 expression is a stage independent prognostic marker in CLL. However, interlaboratory variation is large, and there is neither a consensus nor a regulatory approved methodology. METHODS Two anti-ZAP70 clones (1E7.2 and SBZAP) were compared in 45 untreated CLL patients. Nine different methods for ZAP-70 expression analysis were evaluated: M1, isotype control to determine negative; M2, internal residual T-cell to determine positive; M3, normal donor (ND) T-cell to determine positive; M4, internal T-cell/clone ratio; M5, ND residual T-cell/clone ratio; M6, clone/normal remaining B-cell ratio; M7, clone/ND B- cell ratio; M8, CLL-Z score; M9, modified CLL-Z score. A scoring system was designed integrating both 1E7.2 and SBZAP clones to assign ZAP-70 expression. RESULTS The correlation coefficients for the four selected highest statistically significant methods were as follows (M1 = 0.71, M3 = 0.72, M7 = 0.67, and M9 = 0.64). These four methods were used to generate a combined score. The two reagents showed agreement using the designed scoring system for 37/45 samples (82%), and 8/45 (18%) showed equivocal result with one of the two clones. Seven of the eight equivocal samples were resolved using the scoring system. CONCLUSIONS Four of the nine methods of analysis were compared for each reagent. The use of two independent ZAP-70 reagents increases analytical certitude and the scoring method aids in the resolution of equivocal results. The combined use of two reagents, four methods of analysis, and a scoring method allowed for assignment of ZAP-70 expression in 44/45 samples (98%) tested and improved performance of this important prognostic assay.
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MESH Headings
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal/blood
- Antibody Specificity
- Antigens, Surface/blood
- Antigens, Surface/immunology
- Female
- Flow Cytometry/methods
- Gene Expression/immunology
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Male
- Middle Aged
- ZAP-70 Protein-Tyrosine Kinase/blood
- ZAP-70 Protein-Tyrosine Kinase/immunology
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Affiliation(s)
- Heba A. Degheidy
- Center for Biologics Evaluation and Research, FDA, Bethesda, MD, USA
| | | | | | - Fatima Abbasi
- Center for Biologics Evaluation and Research, FDA, Bethesda, MD, USA
| | | | | | | | | | - Gerald E. Marti
- Center for Biologics Evaluation and Research, FDA, Bethesda, MD, USA
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Progressive but previously untreated CLL patients with greater array CGH complexity exhibit a less durable response to chemoimmunotherapy. ACTA ACUST UNITED AC 2011; 203:161-8. [PMID: 21156228 DOI: 10.1016/j.cancergencyto.2010.09.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 08/31/2010] [Accepted: 09/01/2010] [Indexed: 11/23/2022]
Abstract
To better understand the implications of genomic instability and outcome in B-cell chronic lymphocytic leukemia (CLL), we sought to address genomic complexity as a predictor of chemosensitivity and ultimately clinical outcome in this disease. We used array-based comparative genomic hybridization (aCGH) with a one-million probe array and identified gains and losses of genetic material in 48 patients treated on a chemoimmunotherapy clinical trial. We identified chromosomal gain or loss in ≥6% of the patients on chromosomes 3, 8, 9, 10, 11, 12, 13, 14, and 17. Higher genomic complexity, as a mechanism favoring clonal selection, was associated with shorter progression-free survival, and predicted a poor response to treatment. Of interest, CLL cases with loss of p53 surveillance showed more complex genomic features and were found both in patients with a 17p13.1 deletion and in the more favorable genetic subtype characterized by the presence of 13q14.1 deletion. This aCGH study adds information on the association between poor trial response and increasing genetic complexity as CLL progresses.
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Sholl LM, Longtine J. Molecular analysis of genetic markers for non-Hodgkin lymphomas. CURRENT PROTOCOLS IN HUMAN GENETICS 2010; Chapter 10:Unit 10.14.1-25. [PMID: 20373512 DOI: 10.1002/0471142905.hg1014s65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Molecular analysis complements the clinical and histopathologic tools used to diagnose and subclassify hematologic malignancies. The presence of clonal antigen-receptor gene rearrangements can help to confirm the diagnosis of a B or T cell lymphoma and can serve as a fingerprint of that neoplasm to be used in identifying concurrent disease at disparate sites or recurrence at future time points. Certain lymphoid malignancies harbor a characteristic chromosomal translocation, a finding that may have significant implications for an individual's prognosis or response to therapy. The polymerase chain reaction (PCR) is typically used to detect antigen-receptor gene rearrangements as well as specific translocations that can be supplemented by fluorescence in situ hybridization (FISH) and karyotype analysis.
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10
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Bulian P, Del Poeta G, Gattei V. How would I manage a sample submitted for flow cytometry analysis for suspicious chronic lymphocytic leukaemia. Hematol Oncol 2009; 27:186-9. [DOI: 10.1002/hon.900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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11
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Steininger C, Rassenti LZ, Vanura K, Eigenberger K, Jäger U, Kipps TJ, Mannhalter C, Stilgenbauer S, Popow-Kraupp T. Relative seroprevalence of human herpes viruses in patients with chronic lymphocytic leukaemia. Eur J Clin Invest 2009; 39:497-506. [PMID: 19490058 PMCID: PMC3709071 DOI: 10.1111/j.1365-2362.2009.02131.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Herpes virus infections may have a significant role in chronic lymphocytic leukaemia (CLL) due to their ability to modulate the host's immune system. MATERIALS AND METHODS We examined the seroprevalence of four herpes viruses [Cytomegalovirus (CMV), Epstein-Barr Virus (EBV), human herpes virus (HHV)-6 and -7] in a cohort of European CLL patients (cohort 1, n = 100) in relation to the immunoglobulin variable heavy (IGHV) chain gene use and compared serological results with those obtained from age- and gender-matched healthy adults (n = 100). RESULTS CMV-seroprevalence was significantly higher in CLL cohort 1 (79%) than in the control cohort (57%, P = 0.001); the seroprevalence of EBV (89% vs. 94%), HHV-6 (73% vs. 60%), or HHV-7 (35% vs. 35%) was not. In CLL cohort 1, use of IGHV3-30 was more prevalent among CMV-seropositive and of IGHV3-21 among HHV-7-seronegative cases. To investigate the generalizability of these findings, we investigated the herpes virus seroprevalence in a second cohort of age-matched CLL patients from a different geographical area (USA, n = 100, cohort 2). In cohort 2, CMV-seroprevalence was comparable with that of the control cohort (53%). Seroprevalence of EBV, HHV-6 and HHV-7 were 85%, 88% and 73% respectively. In CLL cohort 2, use of IGHV3-30 or IGHV3-21 was not associated with any of the herpes viruses investigated. CONCLUSIONS CMV-seropositivity is associated with CLL in selected patient cohorts. However, the considerable variation in herpes virus-specific seropositivity between geographically distinct CLL cohorts indicates that seropositivity for any of the four human herpes viruses investigated is not generally associated with CLL.
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Affiliation(s)
- C Steininger
- Department of Medicine I, Medical University of Vienna, Vienna, Austria.
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FCRL2 expression predicts IGHV mutation status and clinical progression in chronic lymphocytic leukemia. Blood 2008; 112:179-87. [PMID: 18314442 DOI: 10.1182/blood-2008-01-131359] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
CD38 and ZAP-70 are both useful prognostic markers for B-cell chronic lymphocytic leukemia (CLL), but are variably discordant with IGHV mutation status. A total of 5 human Fc receptor-like molecules (FCRL1-5) have tyrosine-based immunoregulatory potential and are expressed by B-lineage subpopulations. To determine their prognostic potential in CLL, FCRL expression was compared with IGHV mutation status, CD38 and ZAP-70 expression, and clinical features from 107 patients. FCRL1, FCRL2, FCRL3, and FCRL5 were found at markedly higher levels on CLL cells bearing mutated IGHV genes than on unmutated CLL cells or CD19(+) polyclonal B lymphocytes. Univariate comparisons found that similar to CD38 and ZAP-70, FCRL expression was strongly associated with IGHV mutation status; however, only FCRL2 maintained independent predictive value by multivariate logistic analysis. Strikingly, FCRL2 demonstrated 94.4% concordance with IGHV mutation compared with 76.6% for CD38 and 80.4% for ZAP-70. Compared with other indicators, FCRL2 was also superior at predicting the time to first therapy; the median treatment-free interval was 15.5 years for patients with high FCRL2 expression compared with 3.75 years for FCRL2-low patients. Our studies indicate that FCRL2 has robust predictive value for determining IGHV gene mutation status and clinical progression and thus may further improve prognostic definition in CLL.
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Abstract
Flow cytometric immunophenotyping remains an indispensable tool for the diagnosis, classification, staging, and monitoring of hematologic neoplasms. The last 10 years have seen advances in flow cytometry instrumentation and availability of an expanded range of antibodies and fluorochromes that have improved our ability to identify different normal cell populations and recognize phenotypic aberrancies, even when present in a small proportion of the cells analyzed. Phenotypically abnormal populations have been documented in many hematologic neoplasms, including lymphoma, chronic lymphoid leukemias, plasma cell neoplasms, acute leukemia, paroxysmal nocturnal hemoglobinuria, mast cell disease, myelodysplastic syndromes, and myeloproliferative disorders. The past decade has also seen refinement of the criteria used to identify distinct disease entities with widespread adoption of the 2001 World Health Organization (WHO) classification. This classification endorses a multiparametric approach to diagnosis and outlines the morphologic, immunophenotypic, and genotypic features characteristic of each disease entity. When should flow cytometric immunophenotyping be applied? The recent Bethesda International Consensus Conference on flow cytometric immunophenotypic analysis of hematolymphoid neoplasms made recommendations on the medical indications for flow cytometric testing. This review discusses how flow cytometric testing is currently applied in these clinical situations and how the information obtained can be used to direct other testing.
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Marti G, Orfao A, Goolsby C. ZAP-70 in CLL: towards standardization of a biomarker for patient management: history of clinical cytometry special issue. CYTOMETRY PART B-CLINICAL CYTOMETRY 2007; 70:197-200. [PMID: 16906575 DOI: 10.1002/cyto.b.20137] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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