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Published on: November 10, 2017
Millipore filter vs cytocentrifuge for detection of childhood central nervous system leukemia
Abstract:
To evaluate the relative merits and deficiencies of Millipore filter and cytocentrifuge preparations in the detection of central nervous system (CNS) acute leukemia in pediatric patients, 300 cerebrospinal fluid (CSF) specimens from 17 patients were prepared by both methods. The 17 patients studied were all diagnosed and treated for CNS leukemia. Leukemic blast cells were found by at least one method in 91 CSF specimens, and the results of both techniques were positive in 77 (85%) of 91 specimens. Of the 14 specimens in which the results of only one method were positive, seven yielded positive results only by the cytocentrifuge method, and seven yielded positive results only by the Millipore filter method. In 12 of the 14 discrepant specimens, the paired specimen whose results were not interpreted as positive was technically unsatisfactory (nine specimens) or had cells suspicious for blast cells rather than unequivocal blast cells (three specimens). Blast cells were identified in specimens with low nucleated cell counts (less than or equal to 5/mm3) by both methods and usually were immediately preceded or followed by CSF specimens showing florid disease. We conclude that performance of both methods is unnecessary for routine surveillance if processing techniques yield quality preparations. Cytocentrifuge preparations stained by Wright's method allow better morphologic correlation with bone marrow blast cells and allow easier identification of blood or bone marrow contamination.
Insights
For pediatric acute leukemia detection in cerebrospinal fluid (CSF), cytocentrifuge preparations offer superior morphologic correlation and contamination identification compared to Millipore filters.
Area of Science:
- Pediatric Hematology Oncology
- Clinical Pathology
- Diagnostic Cytology
Background:
- Accurate detection of central nervous system (CNS) acute leukemia in pediatric patients is critical for effective treatment.
- Cerebrospinal fluid (CSF) analysis is essential for diagnosing and monitoring CNS leukemia.
- Millipore filter and cytocentrifuge preparations are common methods for CSF analysis.
Purpose of the Study:
- To compare the diagnostic efficacy of Millipore filter and cytocentrifuge preparations for detecting CNS acute leukemia in pediatric patients.
- To evaluate the relative strengths and weaknesses of each method in identifying leukemic blast cells in CSF.
Main Methods:
- A comparative study involving 300 CSF specimens from 17 pediatric patients diagnosed with CNS leukemia.
- CSF specimens were processed using both Millipore filter and cytocentrifuge preparation techniques.
- Detection of leukemic blast cells was performed on all prepared specimens.
Main Results:
- Both methods detected leukemic blast cells in 91 CSF specimens, with 85% concordance (77 specimens positive by both).
- Of the 14 discrepant results, 12 were due to technical issues or suspicious, non-unequivocal cells.
- Cytocentrifuge preparations demonstrated better morphologic correlation with bone marrow and easier identification of contamination.
Conclusions:
- Performing both Millipore filter and cytocentrifuge preparations is not routinely necessary for CNS leukemia surveillance if quality preparations are achieved.
- Cytocentrifuge preparations are preferred for their superior morphologic assessment and identification of potential contamination.
- Optimized processing techniques are key for reliable detection of pediatric CNS leukemia in CSF.
