081 - Flow cytometric evaluation of cerebrospinal fluid in hematological malignancies
Autor(s): M.M. Ciriello, L. Calcagno, T. Callegari, C. Arfini
Issue: RIMeL - IJLaM, Vol. 6, N. 3-S1, 2010 (MAF Servizi srl ed.)
Page(s): 81-84
The diagnosis of leptomeningeal disease of haematological malgnancies, adverse complication of lymphomas and acute leukemias, has great prognostic and therapeutic implications in patients at high risk of leptomeningeal disease. The diagnostic gold standard to identify cerebrospinal fluid (CSF) involvement is conventional cytological analysis, a technique characterized by low sensitivity and specificity. Recent papers make evidence that the efficiency of CSF involvement detection could improve by use of Flow Cytometry (FCM) immunophenotypic analysis of CSF samples. The National Comprhensive Cancer Network (NCCN) guidelines 2010 (Clinical Practice Guidelines in Oncology) recommends CSF flow cytometric analysis in patient’s CSF with hematologic malignancies. Since2006 is taking place a multicentric prospective italian study by Multiregional Italian Group for Leukemias and Lymphomas (GIMURELL), with the primary objective to compare conventional cytology versus FCM of cerebrospinal fluid in a large cohort of patients with newly diagnosed aggressive non-Hodgkin’s lymphoma at high risk for leptomeningeal disease. All this indicates the great current interest of the scientific community for analyzing cerebrospinal fluid by FCM, a technique which allows the identification of malignant cells with an objective method, using evidence of clonal kappa/lambda restriction in B-cell lymphomas or aberrant phenotypes in T-cell lymphomas.