Background: Chronic lymphoproliferative disorders (CLPDs) encompass a wide range of neoplasms with distinct clinical and laboratory features. The overlap between these entities is not uncommon as is variability within each. Hence the diagnosis of CLPDs requires a multi-parameter approach starting with the clinical profile and morphological evaluation along with the integration of bits of information from various investigations to direct therapeutic decisions. Flow cytometry(FCM) holds a pivotal position in the diagnostic algorithm.There are not many studies on CLPDs among Asians. Here, we have looked into the profile of suspected CLPD cases received for immunophenotyping at our institution over one year.
Methods: The list of samples subjected to flow cytometry in view of suspicion of chronic lymphoproliferative disorder (CLPD), over a year, was obtained and the details of the patients retrieved from the electronic medical records. Morphology of their lymphoid cells in peripheral blood or bone marrow aspirates and immunophenotype as inferred from FCM were carefully studied in the light of clinical profile.
Results: 74% of the samples revealed clonal lymphoid populations, the majority being of B lineage and chronic lymphocytic leukaemia (CLL) was the most frequent subtype(45%). B-CLPDs other than classical CLL and hairy cell leukaemia posed difficulties in subtyping. Two cases of Hodgkin lymphoma were not evident on FCM. However small neoplastic clones could be picked up in marrow samples sent for the staging of lymphomas.
Conclusion: We found FCM to be a useful tool in delineating and categorising neoplastic lymphoid proliferations so as to guide management decisions especially when tissue biopsy was not available. The scope of FCM has expanded to yield much more therapeutic and prognostic information. Newer modalities like molecular testing are also entering the scene though many are yet to be approved for routine practice.
Impact Factor
2022: 6.012
This work is licensed under a