High sensitivity of flow cytometry improves detection of occult leptomeningeal disease in acute lymphoblastic leukemia and lymphoblastic lymphoma

Conventional cytology (CC) of cerebrospinal fluid (CSF) fails to demonstrate malignant cells in up to 45 % of patients with acute lymphoblastic leukemia or lymphoblastic lymphoma (ALL/LL) in whom occult leptomeningeal disease is present. Flow cytometry (FCM) is considered more sensitive than CC, but...

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Bibliographic Details
Published in:Annals of hematology 2014-09, Vol.93 (9), p.1509-1513
Main Authors: Del Principe, Maria Ilaria, Buccisano, Francesco, Cefalo, Mariagiovanna, Maurillo, Luca, Di Caprio, Luigi, Di Piazza, Fabio, Sarlo, Chiara, De Angelis, Gottardo, Irno Consalvo, Maria, Fraboni, Daniela, De Santis, Giovanna, Ditto, Concetta, Postorino, Massimiliano, Sconocchia, Giuseppe, Del Poeta, Giovanni, Amadori, Sergio, Venditti, Adriano
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Cytodiagnosis - methods
Female
Flow Cytometry - methods
Hematology
Humans
Leukemic Infiltration - cerebrospinal fluid
Leukemic Infiltration - diagnosis
Male
Medicine
Medicine & Public Health
Meningeal Neoplasms - cerebrospinal fluid
Meningeal Neoplasms - etiology
Meningeal Neoplasms - pathology
Meninges - pathology
Middle Aged
Oncology
Original Article
Precursor Cell Lymphoblastic Leukemia-Lymphoma - cerebrospinal fluid
Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications
Sensitivity and Specificity
Young Adult
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Description
Summary:Conventional cytology (CC) of cerebrospinal fluid (CSF) fails to demonstrate malignant cells in up to 45 % of patients with acute lymphoblastic leukemia or lymphoblastic lymphoma (ALL/LL) in whom occult leptomeningeal disease is present. Flow cytometry (FCM) is considered more sensitive than CC, but clinical implications of CC negativity/CC positivity are not yet established. CSF samples from 38 adult patients with newly diagnosed ALL/LL were examined. Five (13 %) and nine (24 %) specimens were CC positive-FC positive (FCM pos /CC pos ) and CC negative-FC positive (CC neg /FCM pos ), respectively. The remaining 24 (63 %) samples were double negative (CC neg /FCM neg ) ( p  = 0.001). CC neg /FCM pos patients showed a significantly shorter overall survival (OS) compared to CC neg /FCM neg ones. In multivariate analysis, the status of single FCM positivity was demonstrated to affect independently duration of OS ( p  = 0.005). In conclusion, FCM significantly improves detection of leptomeningeal occult localization in ALL/LL and appears to anticipate an adverse outcome. Further prospective studies on larger series are needed to confirm this preliminary observation.
ISSN:0939-5555
1432-0584
DOI:10.1007/s00277-014-2080-6