Flow cytometry for meningeal infiltration in B acute lymphoblastic leukemia in a low middle income country

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
Eya Anane, Fatma Ben Lakhal, Sarra Fekih Salem, Ons Ghali, Emna Feki, Yosr Ben Abdennebi, Marwa Bahri, Emna Azza, Lamia Aissaoui, Wijden El Borgi, Emna Gouider
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Abstract

Meningeal infiltration in children with B acute lymphoblastic leukemia is one of the most serious complications. Timely diagnosis not only significantly enhances treatment efficacy but also leads to improve patient outcome and reduce risk of relapse. This is particularly crucial in low to middle income countries facing health constraints, where optimizing resources is essential. Conventional cytology (CC) study of cerebrospinal fluid (CSF) is considered in different countries to be the Gold-standard despite its low sensitivity (< 50%). The study of CSF by multiparametric flow cytometry (MFC) appears to be an alternative. The aim of our study was to assess MFC analytical performance compared with CC. Our cross sectional study was conducted over a six-month period in the biological hematology department. CSF samples underwent analysis for the presence of blasts using both CC and MFC. Cytological slides of the CSF were prepared by cytocentrifugation in a Shandon Cytospin 4™. Flow cytometric analysis was performed on the BD FACSLyric™ flow cytometer. All statistical analyses were performed using SPSS version 21.0 (SPSS Inc.). Agreement between the two methods was made using the Kappa index and χ2 test. This study was approved by the local ethics committee. Sixty CSF samples from 39 children with B acute lymphoblastic leukemia were analyzed. Meningeal infiltration was detected respectively in 20% of cases by MFC and 5% of cases by CC, with a significant difference p = 0.006. Comparing the two methods, the Kappa coefficient was 0.35, indicating weak agreement between the two methods. Moreover, MFC positivity was higher even for hypocellular samples. Of the 51 hypocellular samples, eight were positive by MFC while they were negative by CC. MFC shows better sensitivity while retaining good specificity for the detection of meningeal involvement. MFC could therefore be a complementary method to CC for detecting blast cells in the central nervous system.

流式细胞术检测中低收入国家 B 型急性淋巴细胞白血病的脑膜浸润。
B 型急性淋巴细胞白血病患儿的脑膜浸润是最严重的并发症之一。及时诊断不仅能显著提高治疗效果,还能改善患者预后,降低复发风险。这对于面临医疗限制的中低收入国家尤为重要,因为这些国家必须优化资源。脑脊液(CSF)的常规细胞学(CC)研究在不同国家被视为黄金标准,尽管其敏感性较低(2 检验)。本研究获得了当地伦理委员会的批准。本研究分析了 39 名 B 型急性淋巴细胞白血病患儿的 60 份脑脊液样本。MFC和CC分别有20%和5%的病例检测到脑膜浸润,差异显著(P = 0.006)。比较两种方法,卡帕系数为 0.35,表明两种方法的一致性较弱。此外,即使是低细胞样本,MFC 阳性率也较高。在 51 份低细胞样本中,有 8 份样本的 MFC 检测结果呈阳性,而 CC 检测结果呈阴性。MFC 在检测脑膜受累方面显示出更高的灵敏度,同时保留了良好的特异性。因此,MFC 可作为 CC 的补充方法,用于检测中枢神经系统中的爆炸细胞。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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