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Detection of leukemic lymphoblasts in CSF is instrument-dependent
Alison R Huppmann1, Susan R Rheingold, L Charles Bailey
1Department of Pathology, The Children’s Hospital of Philadelphia, PA, USA.
American Journal of Clinical Pathology
|April 24, 2012
Summary
Newer cytocentrifuge machines for pediatric acute lymphoblastic leukemia (ALL) testing detect more leukemic blasts in cerebrospinal fluid (CSF). This instrument-dependent finding may improve leukemia monitoring, though clinical significance is under investigation.
Area of Science:
- Hematology
- Clinical Pathology
- Medical Technology
Background:
- Cerebrospinal fluid (CSF) analysis is crucial for staging and monitoring pediatric acute lymphoblastic leukemia (ALL).
- An increased incidence of low-level leukemic blasts in CSF was observed at our institution.
- This increase correlated with a change in cytocentrifuge equipment from Shandon CytoSpin 4 to Wescor Cytopro Rotor AC-060.
Purpose of the Study:
- To directly compare the diagnostic performance of the Shandon CytoSpin 4 and Wescor Cytopro Rotor AC-060 cytocentrifuges.
- To evaluate the impact of cytocentrifuge technology on the detection of leukemic blasts in CSF samples from ALL patients.
Main Methods:
- Direct comparison of Shandon CytoSpin 4 and Wescor Cytopro Rotor AC-060 using patient CSF samples.
- Utilized known concentrations of cultured leukemia cells to validate instrument performance.
- Quantified the number of cells and detected leukemic blasts on prepared slides.
Main Results:
- The Wescor Cytopro yielded a 5- to 9-fold increase in cell count on slides compared to the Shandon CytoSpin.
- Leukemic blasts were detected in 2 patient samples exclusively with the Wescor Cytopro.
- Similar enhanced detection of blasts was observed when using cultured leukemia cells.
Conclusions:
- Detection of leukemic blasts in CSF is significantly dependent on the cytocentrifuge instrument used.
- More sensitive, modern cytocentrifuges can identify blasts missed by older technologies.
- The clinical significance of detecting these previously missed blasts requires further investigation.
