Flow cytometry and cytomorphology evaluation of hematologic malignancy in cerebrospinal fluids: Comparison with retrospective clinical outcome

Clara Cesana, Catherine Klersy, Barbara Scarpati, Bruno Brando, Maurizio Faleri, Giambattista Bertani, Arianna Gatti, Elisabetta Volpato, Claudia Barba, Ursula Ferri, Linda Scampini, Giovanni Grillo, Giuliana Lando, Annamaria Nosari, Enrica Morra, Roberto Cairoli

Research output: Contribution to journalArticle

Abstract

An independent clinical assessment was compared with flow cytometry (FCM) and cytomorphology results obtained on 227 cerebrospinal fluids investigated for hematologic malignancy, in a retrospective longitudinal study with a median observation time of 11 months. A combined method assessment (CMA), defining "positive" a sample if at least one method gave "positive" results, was also tested. Eleven out of 55 screening samples and 53 out of 166 follow-up samples resulted positive at clinical evaluation. FCM and CM were concordant with positive clinical assessment in 68.5% and 51.5% of cases, respectively. According to CMA, 10.5% of samples (resulting false negative by either FCM or cytomorphology) were rescued as true positive. FCM retained significantly higher accuracy than cytomorphology (p = 0.0065) and 100% sensitivity when at least 220 leukocytes were acquired. CMA accuracy was higher than FCM accuracy and significantly higher than cytomorphology accuracy in the analysis of all samples (p <0.0001), samples from mature B/T cell neoplasms (p = 0.0021), and samples drawn after intrathecal treatment (p = 0.0001). When acquiring ≥220 leukocytes, FCM accuracy was poor, and combining cytomorphology added statistically significant diagnostic advantage (p = 0.0043). Although FCM is the best diagnostic tool for evaluating CSF, morphology seems helpful especially when clinically positive follow-up samples are nearly acellular.

Original languageEnglish
Pages (from-to)827-835
Number of pages9
JournalAnnals of Hematology
Volume90
Issue number7
DOIs
Publication statusPublished - Jul 2011

Keywords

  • Cerebrospinal fluid
  • Cytomorphology
  • Flow cytometry
  • Hematologic malignancy
  • Lymphoid neoplasm

ASJC Scopus subject areas

  • Hematology

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  • Cite this

    Cesana, C., Klersy, C., Scarpati, B., Brando, B., Faleri, M., Bertani, G., Gatti, A., Volpato, E., Barba, C., Ferri, U., Scampini, L., Grillo, G., Lando, G., Nosari, A., Morra, E., & Cairoli, R. (2011). Flow cytometry and cytomorphology evaluation of hematologic malignancy in cerebrospinal fluids: Comparison with retrospective clinical outcome. Annals of Hematology, 90(7), 827-835. https://doi.org/10.1007/s00277-010-1145-4