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[Morphology and immunophenotyping in hematological malignancies]
1Department of Laboratory Medicine, Keio University, School of Medicine, Tokyo.
Insights
Morphologic and immunophenotypic analysis are essential for accurate laboratory hematology diagnoses. Immunophenotyping significantly improves diagnostic rates, especially for non-Hodgkin lymphoma (NHL), aiding rapid and precise patient care.
Area of Science:
- Hematology
- Immunology
- Oncology
Context:
- Evaluated 443 patients at Keio University Hospital (1994-1999).
- Utilized morphology, cytochemistry, and laser flow cytometry for immunophenotyping.
- Integrated cytogenetic and molecular genetic data for comprehensive diagnosis.
Purpose:
- To assess the diagnostic utility of immunophenotyping compared to morphology in hematologic disorders.
- To determine the diagnostic rate probability of immunophenotypic analysis using multivariate analysis.
- To highlight the essential role of these methods in laboratory hematology.
Summary:
- Diagnosed 150 acute leukemia (59 ALL, 91 AML), 74 MDS, 76 myeloproliferative disorders, 21 CLL-related disorders, 104 malignant lymphoma, and 18 multiple myeloma cases.
- Immunophenotyping achieved an average diagnostic rate of 91.7%, with 97.1% for non-Hodgkin lymphoma (NHL).
- Morphologic and immunophenotypic analyses are fundamental for rapid and precise hematologic diagnoses.
Impact:
- Demonstrates the high diagnostic accuracy of immunophenotyping in hematologic malignancies.
- Establishes immunophenotyping as a crucial tool for differentiating complex hematologic disorders.
- Suggests tele-hematology could standardize morphologic methods for future diagnostics.
Abstract:
We evaluated 443 outpatients and inpatients in Keio University Hospital between 1994 and 1999. Morphologic features from peripheral blood and bone marrow aspiration were evaluated in our hematology laboratory, using Wright-Giemsa, peroxidase staining films and other cytochemistry. Immunophenotype was determined by cell surface antigen analysis by laser flow cytometry, FACscan, using various monoclonal antibodies. Information on cytogenetic and molecular genetic characteristics can be also integrated for diagnosis. One hundred fifty patients were diagnosed with acute leukemia, in which 59 cases were ALL and 91 cases were AML. Seventy-four cases were MDS, 76 cases were myeloproliferative disorders, 21 cases were CLL related disorders, 104 patients were malignant lymphoma, and 18 cases were multiple myeloma. The ratio of male to female was 1.7. The probability of diagnostic rate by Immunophenotyping was estimated by Discriminant analysis in 189 patients, using multivariate analysis of immunophenotype compared to morphology. The average probability by immunophenotypic analysis for diagnostic rate was 91.7%, in which the probability for NHL was very high of 97.1%. Thus, morphologic and immunophenotypic analysis is most essential and basic approach in laboratory hematology, from the perspective of rapid and precise diagnostic methods. Recent advance appreciates the rapid contribution for diagnosis by immunophenotypic analysis. Furthermore, Tele-hematology would contribute the standardization for morphologic method in the near future.