PURPOSE: Here, we evaluate the sensitivity and specificity of a new 11-parameter flow cytometry (FCM) approach versus conventional cytology (CC) for detecting neoplastic cells in stabilized CSF samples from newly diagnosed aggressive B-cell non-Hodgkin's lymphoma (B-NHL) at high risk of CNS relapse, using a prospective, multicentric study design. PATIENTS AND METHODS: Moreover, we compared the distribution of different subpopulations of CSF leukocytes and the clinico-biologic characteristics of CSF+ versus CSF-, patients, in an attempt to define new algorithms useful for predicting CNS disease. RESULTS: Overall, 27 (22%) of 123 patients showed infiltration by FCM, while CC was positive in only seven patients (6%), with three other cases being suspicious (2%). CC+/FCM+ samples typically had more than 20% neoplastic B cells and/or >or= one neoplastic B cell/microL, while FCM+/CC- samples showed lower levels (P < .0001) of infiltration. Interestingly, in Burkitt lymphoma, presence of CNS disease by FCM could be predicted with a high specificity when increased serum beta2-microglobulin and neurological symptoms coexisted, while peripheral blood involvement was the only independent parameter associated with CNS disease in diffuse large B-cell lymphoma, with low predictive value. CONCLUSION: FCM significantly improves the sensitivity of CC for the identification of leptomeningeal disease in aggressive B-NHL at higher risk of CNS disease, particularly in paucicellular samples.
PURPOSE: Here, we evaluate the sensitivity and specificity of a new 11-parameter flow cytometry (FCM) approach versus conventional cytology (CC) for detecting neoplastic cells in stabilized CSF samples from newly diagnosed aggressive B-cell non-Hodgkin's lymphoma (B-NHL) at high risk of CNS relapse, using a prospective, multicentric study design. PATIENTS AND METHODS: Moreover, we compared the distribution of different subpopulations of CSF leukocytes and the clinico-biologic characteristics of CSF+ versus CSF-, patients, in an attempt to define new algorithms useful for predicting CNS disease. RESULTS: Overall, 27 (22%) of 123 patients showed infiltration by FCM, while CC was positive in only seven patients (6%), with three other cases being suspicious (2%). CC+/FCM+ samples typically had more than 20% neoplastic B cells and/or >or= one neoplastic B cell/microL, while FCM+/CC- samples showed lower levels (P < .0001) of infiltration. Interestingly, in Burkitt lymphoma, presence of CNS disease by FCM could be predicted with a high specificity when increased serum beta2-microglobulin and neurological symptoms coexisted, while peripheral blood involvement was the only independent parameter associated with CNS disease in diffuse large B-cell lymphoma, with low predictive value. CONCLUSION: FCM significantly improves the sensitivity of CC for the identification of leptomeningeal disease in aggressive B-NHL at higher risk of CNS disease, particularly in paucicellular samples.
Authors: Prashant Tembhare; Constance M Yuan; John C Morris; John E Janik; Armando C Filie; Maryalice Stetler-Stevenson Journal: Am J Clin Pathol Date: 2012-02 Impact factor: 2.493
Authors: J J M van Dongen; L Lhermitte; S Böttcher; J Almeida; V H J van der Velden; J Flores-Montero; A Rawstron; V Asnafi; Q Lécrevisse; P Lucio; E Mejstrikova; T Szczepański; T Kalina; R de Tute; M Brüggemann; L Sedek; M Cullen; A W Langerak; A Mendonça; E Macintyre; M Martin-Ayuso; O Hrusak; M B Vidriales; A Orfao Journal: Leukemia Date: 2012-05-03 Impact factor: 11.528
Authors: Wyndham H Wilson; Jacoline E C Bromberg; Maryalice Stetler-Stevenson; Seth M Steinberg; Lourdes Martin-Martin; Carmen Muñiz; Juan Manuel Sancho; Maria Dolores Caballero; Marjan A Davidis; Rik A Brooimans; Blanca Sanchez-Gonzalez; Antonio Salar; Eva González-Barca; Jose Maria Ribera; Margaret Shovlin; Armando Filie; Kieron Dunleavy; Thomas Mehrling; Michele Spina; Alberto Orfao Journal: Haematologica Date: 2014-04-11 Impact factor: 9.941
Authors: Francisco-Javier Peñalver; Juan-Manuel Sancho; Adolfo de la Fuente; María-Teresa Olave; Alejandro Martín; Carlos Panizo; Elena Pérez; Antonio Salar; Alberto Orfao Journal: Haematologica Date: 2016-10-20 Impact factor: 9.941
Authors: Brian J Scott; Vanja C Douglas; Tarik Tihan; James L Rubenstein; S Andrew Josephson Journal: JAMA Neurol Date: 2013-03-01 Impact factor: 18.302