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Development of an algorithm for the identification of leukemic hematolymphoid neoplasms in Primary Care patients.
- Source :
-
Diagnosis (Berlin, Germany) [Diagnosis (Berl)] 2020 Apr 09; Vol. 8 (2), pp. 239-247. Date of Electronic Publication: 2020 Apr 09 (Print Publication: 2021). - Publication Year :
- 2020
-
Abstract
- Background: Diagnosis of hematolymphoid neoplasm (HLN) requires different technologies which are performed on a patient basis instead of per protocol. We hypothesize that integration of hematimetric and cytological analysis along with multiparametric flow cytometry (MFC) provides a framework to evaluate peripheral blood (PB) samples from Primary Care.<br />Methods: Samples from patients with persistent (>3 months) lymphocytosis (>5 × 10 <superscript>9</superscript> /L) and/or monocytosis (>10 <superscript>9</superscript> /L) or the presence of atypical and/or blast cells upon the smear review were analyzed by MFC concurrent to cytological analysis. MFC studies were carried out following standardized procedures.<br />Results: In a 3-year period, smear review and MFC were performed simultaneously in 350 samples, demonstrating HLN in 194 cases (55.4%). In 156 cases, reactive cell populations were found. The combination of age, absolute lymphocyte count (ALC), hemoglobin and platelets provided the best correlation with MFC for the presence of a chronic lymphoproliferative disorder (CLPD) in lymphocytosis [area under the curve (AUC) 0.891, p < 0.05]. A model evaluating the probability of CLPD has been proposed and validated in an independent cohort.<br />Conclusions: A strategy to perform MFC studies following standardized procedures has proven to be useful to evaluate samples from patients in Primary Care centers for HLN diagnosis or reactive conditions, providing a sensitive and rapid clinical orientation and avoiding unnecessary consultations in routine clinical practice. The probability for the presence of CLPD in PB can be calculated and help guide decision-making regarding further testing.<br /> (©2020 Walter de Gruyter GmbH, Berlin/Boston.)
Details
- Language :
- English
- ISSN :
- 2194-802X
- Volume :
- 8
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Diagnosis (Berlin, Germany)
- Publication Type :
- Academic Journal
- Accession number :
- 32284442
- Full Text :
- https://doi.org/10.1515/dx-2020-0021