High Counts in Hematologic Malignancies Predict Low Metaphase Yield for Cytogenetic Analysis

Area of Science:

• Hematology
• Cytogenetics
• Oncology

Background:

• Cytogenetic analysis is crucial for diagnosing and classifying hematologic malignancies.
• Metaphase yield, the number of metaphases available for analysis, can significantly impact diagnostic accuracy.
• Preanalytical variables can influence metaphase yield, but their impact in hematologic malignancies requires further elucidation.

Purpose of the Study:

• To investigate the association between preanalytical variables and low metaphase yield (LNM) in hematologic malignancies.
• To identify specific factors that predict inadequate metaphase yield for cytogenetic studies.

Main Methods:

• Retrospective analysis of 455 bone marrow samples from patients with hematologic malignancies undergoing cytogenetic analysis.
• Categorization of samples into adequate metaphase yield (≥20 metaphases) and low metaphase yield (<20 metaphases).
• Statistical analysis of age, sex, nucleated cell (MNC) count, and peripheral blood counts (hemoglobin, WBC, platelets) for association with LNM.

Main Results:

• 17% of samples exhibited LNM, with 6% yielding no metaphases.
• Significantly higher MNC and white blood cell (WBC) counts were observed in the LNM group (P < .001 for both).
• Elevated MNC counts were also noted in LNM subgroups of acute myeloid leukemia and acute lymphoblastic leukemia. Receiver operating characteristic curves indicated moderate predictive value for MNC and WBC counts for LNM.

Conclusions:

• Low metaphase yield is a frequent challenge in hematologic malignancies, particularly those with elevated cell counts.
• High bone marrow nucleated cell and peripheral blood white blood cell counts are associated with LNM.
• These findings suggest potential biological factors inherent to certain hematologic malignancies that influence metaphase yield, warranting further investigation.