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Flow cytometric immunophenotyping for hematologic neoplasms
Fiona E Craig1, Kenneth A Foon
1Division of Hematopathology, Department of Pathology, University of Pittsburgh School of Medicine, PA, USA. craigfe@upmc.edu
Insights
Flow cytometric immunophenotyping is crucial for diagnosing and monitoring blood cancers. Advances in technology enhance the identification of abnormal cells, aiding in precise classification and treatment guidance.
Area of Science:
- Hematology
- Immunology
- Molecular Biology
Background:
- Flow cytometric immunophenotyping is essential for diagnosing, classifying, staging, and monitoring hematologic neoplasms.
- Recent advancements in instrumentation, antibodies, and fluorochromes have improved the detection of abnormal cell populations.
Purpose of the Study:
- To review the current applications of flow cytometric immunophenotyping in hematologic neoplasms.
- To discuss how flow cytometry data aids in diagnosis and directs further testing.
Main Methods:
- Review of recent literature and clinical guidelines.
- Discussion of multiparametric approaches integrating morphology, immunophenotype, and genotype.
- Incorporation of recommendations from the Bethesda International Consensus Conference.
Main Results:
- Phenotypic abnormalities are documented in various hematologic neoplasms.
- The 2001 World Health Organization (WHO) classification emphasizes a multiparametric diagnostic approach.
- Consensus conferences provide guidelines for the medical indications of flow cytometric testing.
Conclusions:
- Flow cytometry is indispensable for hematologic neoplasm management.
- Improved technology enhances sensitivity for detecting minimal disease.
- Standardized criteria and consensus guidelines refine diagnostic accuracy and clinical application.
Abstract:
Flow cytometric immunophenotyping remains an indispensable tool for the diagnosis, classification, staging, and monitoring of hematologic neoplasms. The last 10 years have seen advances in flow cytometry instrumentation and availability of an expanded range of antibodies and fluorochromes that have improved our ability to identify different normal cell populations and recognize phenotypic aberrancies, even when present in a small proportion of the cells analyzed. Phenotypically abnormal populations have been documented in many hematologic neoplasms, including lymphoma, chronic lymphoid leukemias, plasma cell neoplasms, acute leukemia, paroxysmal nocturnal hemoglobinuria, mast cell disease, myelodysplastic syndromes, and myeloproliferative disorders. The past decade has also seen refinement of the criteria used to identify distinct disease entities with widespread adoption of the 2001 World Health Organization (WHO) classification. This classification endorses a multiparametric approach to diagnosis and outlines the morphologic, immunophenotypic, and genotypic features characteristic of each disease entity. When should flow cytometric immunophenotyping be applied? The recent Bethesda International Consensus Conference on flow cytometric immunophenotypic analysis of hematolymphoid neoplasms made recommendations on the medical indications for flow cytometric testing. This review discusses how flow cytometric testing is currently applied in these clinical situations and how the information obtained can be used to direct other testing.
