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Bone Marrow Immunohistochemistry and Flow Cytometry in the Diagnosis of Malignant Hematologic Diseases With Emphasis

Maude Landry1, Marc-Nicolas Bienz2, Bassem Sawan3,4

  • 1Department of Hematology/Oncology, Division of Hematology.

Applied Immunohistochemistry & Molecular Morphology : AIMM
|July 11, 2019
PubMed

Insights

Immunohistochemistry (IHC) and flow cytometry (FC) show substantial agreement in diagnosing hematologic malignancies like lymphomas. While both methods are valuable, IHC excels in lymphoma diagnosis, and FC is crucial for leukemias and monitoring minimal residual disease.

Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Accurate diagnosis of hematologic malignancies is crucial for effective treatment.
  • Immunohistochemistry (IHC) and flow cytometry (FC) are key diagnostic tools.
  • Evaluating the concordance between IHC and FC is essential for optimizing diagnostic workflows.

Purpose of the Study:

  • To assess the agreement between IHC and FC in diagnosing malignant hematologic diseases, particularly lymphomas.
  • To determine the concordance rates for various hematologic neoplasms.
  • To identify the unique contributions of each method in non-concordant cases.

Main Methods:

  • Retrospective analysis of 260 patients diagnosed with hematologic malignancy between 2009 and 2012.
  • Inclusion of bone marrow biopsies, aspirates, and other cell suspensions analyzed by both IHC and FC.
  • Calculation of agreement using the kappa statistic (κ).

Main Results:

  • A substantial overall agreement (κ=0.69) was observed between IHC and FC.
  • High concurrence rates (>80%) were found in chronic lymphocytic leukemia/small lymphocytic lymphoma, mature T-cell neoplasms, acute leukemias, and myelodysplastic syndromes.
  • In non-concordant cases, IHC provided the diagnosis in 25.4% and FC in 4.6%; IHC alone diagnosed 51% of lymphomas.

Conclusions:

  • IHC and FC demonstrate good concordance and are complementary diagnostic methods for hematologic malignancies.
  • IHC offers advantages in lymphoma diagnosis by integrating markers, morphology, and tissue architecture.
  • FC is essential for leukemia diagnosis, offering speed and utility in minimal residual disease detection.

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