Health technology assessment-based approach to flow cytometric immunophenotyping of acute leukemias: a literature classification
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Giuseppe Gaipa1, Eugenio Erba2, Marco Danova3
1M. Tettamanti Research Center, Pediatric Clinic, University of Milano Bicocca, Monza, Italy.
Insights
This study systematically reviewed literature on flow cytometric immunophenotyping for acute leukemia (AL) diagnosis. It assessed the accuracy and utility of this technique in identifying, characterizing, and staging AL patients.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Acute leukemia (AL) is a complex group of blood cancers.
- Flow cytometric immunophenotyping is a key diagnostic tool for AL.
- The systematic evaluation of its diagnostic role is lacking.
Purpose of the Study:
- To determine the accuracy and utility of flow cytometric immunophenotyping in AL diagnosis.
- To assess its role in identification, characterization, and staging of AL.
- To provide an evidence-based analysis of its impact on clinical management.
Main Methods:
- Systematic literature review and classification of studies since 1980.
- Focused search on flow cytometric immunophenotyping in AL.
- Application of a 6-variable model for technical and clinical value assessment.
Main Results:
- Screened 1010 articles from PubMed and Embase (1985-2015).
- Analyzed 248 selected articles (160 clinical, 55 technical, 31 reviews).
- Classified articles based on the 6-variable model.
Conclusions:
- Assessed three decades of literature on flow cytometric immunophenotyping in AL.
- Laid the groundwork for evidence-based analysis of the technology's impact.
- Highlighted the importance of this technique in AL clinical management.
Objective:
Acute leukemia (AL) is a broad, heterogeneous group of malignant diseases. The diagnostic workup of AL is based on several clinical and laboratory findings, including flow cytometric immunophenotyping. However, the role of this assay in the diagnosis of AL has not been systematically investigated. The aim of this study was to determine the accuracy and utility of flow cytometric immunophenotyping in the identification, characterization, and staging of AL.
Methods:
We performed a systematic selection and classification of the literature since 1980, focused on flow cytometric immunophenotyping of AL. We applied a 6-variables model to cover both the technical capabilities and the clinical value of flow cytometric immunophenotyping in the diagnosis of AL.
Results:
Using 3 key words (acute leukemia, immunophenotyping, flow cytometry), we screened the literature from January 1985 to April 2015 in PubMed and Embase databases and found 1010 articles. A total of 363 were selected and submitted to the expert panel, which selected a final data set of 248 articles to be analyzed. Of these, 160 were focused on clinical and biological issues, 55 were technical articles, and 31 were reviews. These 248 articles were then analyzed according to the 6-variables model and definitively classified.
Conclusions:
We assessed the literature on flow cytometric immunophenotyping of AL over 3 decades as the first step toward an evidence-based analysis of the impact of this technology on the clinical management of patients with AL.
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