Laboratory practices in reporting flow cytometry phenotyping results for leukemia/lymphoma specimens: results of a...

Laboratory directors who routinely utilize flow cytometry for at least part of their diagnostic evaluations in leukemias or lymphomas were surveyed by mail. The survey consisted of 12 questions about the flow cytometry procedures used by the laboratory in evaluating leukemias and lymphomas and on the format and content of their official report. It also requested an example of a typical leukemia/lymphoma report and solicited write-in comments about additional important aspects of using flow cytometry to evaluate leukemia and lymphomas not covered by the questionnaire. The goal of the survey, which was sponsored by the Clinical Cytometry Society (CCS), was to document what directors of flow cytometry laboratories currently consider to be the appropriate contents of a clinical leukemia/lymphoma phenotyping analysis and in what manner and detail they report such flow cytometry results to clinicians. The survey indicated that a large number of markers are routinely evaluated to phenotype leukemias (mean = 19) and lymphomas (mean = 16). Light scatter gating, using CD45/14 to monitor the gate selected, is currently employed by a 2:1 ratio over the next most population gating strategy (CD45 vs. 90 degrees LS). Peripheral blood, bone marrow, and lymphoid tissue constitute the majority of clinical specimens evaluated for leukemia and/or lymphoma. Two-color analysis, primarily for surface markers, is currently the standard method for flow cytometry measurements in routine diagnostic studies of leukemia and lymphoma. The official flow cytometry laboratory report is most commonly an individual-lab-generated, paper report form. A discussion of the potential benefits that might result from the development of improved computerized reporting software and from the increased use of antibody-defined, lineage gating is offered. A composite report format is presented that demonstrates the flow measurements and quality control data included in the best of the example clinical reports submitted as part of the survey and considered important by a majority of our survey respondents. The example report is intended to be a basis for further discussion within the flow cytometry community on whether minimum reporting standards for leukemia and/or lymphoma flow cytometry results can and should be developed.