RESUMEN
BACKGROUND: Multiparametric flow cytometry (MFC) is a powerful tool for the diagnosis of hematological malignancies and has been useful for the classification of chronic lymphoproliferative disorders (CLPD) according to the WHO criteria. Following the purposes of the Brazilian Group of Flow Cytometry (GBCFLUX), the aim of this report was to standardize the minimum requirements to achieve an accurate diagnosis in CLPDs, considering the different economic possibilities of the laboratories in our country. Most laboratories in Brazil work with 4-fluorescence flow cytometers, which is why the GBCFLUX CLPD Committee has proposed 4-color monoclonal antibody (MoAb) panels. METHODS/RESULTS: Panels for screening and diagnosis in B, T and NK lymphoproliferative disorders were developed based on the normal differentiation pathways of these cells and the most frequent phenotypic aberrations. Important markers for prognosis and for minimal residual disease (MRD) evaluation were also included. The MoAb panels presented here were designed based on the diagnostic expertise of the participating laboratories and an extensive literature review. CONCLUSION: The 4-color panels presented to aid in the diagnosis of lymphoproliferative neoplasms by GBCFLUX aim to provide clinical laboratories with a systematic, step-wise, cost-effective, and reproducible approach to obtain an accurate immunophenotypic diagnosis of the most frequent of these disorders. © 2016 International Clinical Cytometry Society.
Asunto(s)
Citometría de Flujo , Inmunofenotipificación , Trastornos Linfoproliferativos/diagnóstico , Neoplasia Residual/diagnóstico , Antígenos CD/inmunología , Linfocitos B/inmunología , Brasil , Femenino , Citometría de Flujo/métodos , Neoplasias Hematológicas/patología , Humanos , Masculino , PronósticoRESUMEN
BACKGROUND AND PURPOSE: Reticulated platelet (RP) count provides an estimate of thrombopoiesis. The objective was to evaluate RP in patients in different stages of sickle cell disease (SCD) and to determine the relationship between interleukin-6 (IL-6), interleukin-3 (IL-3) and thrombopoietin (TPO) and RP count and degree of activation. METHODS: Eighty-nine adult patients with SCD were studied: 38 were in the steady state, 27 in hemolytic crisis (HC) and 24 in vaso-occlusive crisis (VOC). RPs and activated platelets were analyzed by flow cytometry. Soluble P-selectin, IL-6, IL-3 and thrombopoietin (TPO) levels were measured by ELISA tests. RESULTS: The patients in VOC had a higher absolute number of RPs and CD62P+ platelets than did the control group or patients in the steady state. A significant correlation was observed between the absolute number of CD62P+ platelets and RPs in patients in the steady state, HC and VOC. In the steady-state group of patients, the level of soluble P-selectin was found to be dependent on the RP values. IL-3 and TPO serum levels were higher in patients in the steady state, HC and VOC than in the control group. IL-6 serum levels were higher in HC and VOC patients than in the control group and higher in patients in the steady state than in the VOC group. CONCLUSION: Our results suggest that PRs contribute to the vaso-occlusive process in sickle cell disease. Increased interleukin serum levels probably indicate that inflammatory process is involved in the vascular-occlusive phenomenon. However, it appears that these inflammatory mediators do not have an effect on thrombopoiesis in sickle-cell-disease patients.
Asunto(s)
Anemia de Células Falciformes/sangre , Plaquetas/metabolismo , Adulto , Anemia de Células Falciformes/fisiopatología , Estudios de Casos y Controles , Femenino , Humanos , Interleucina-3/sangre , Interleucina-6/sangre , Masculino , Persona de Mediana Edad , Selectina-P/sangre , Recuento de Plaquetas , Índice de Severidad de la Enfermedad , Trombopoyetina/sangreRESUMEN
Monitoring the timing of leukapheresis in peripheral blood stem cells (PBSC) mobilization is an important clinical decision that requires an accurate analytical tool. The present study assessed hematopoietic progenitor cells (HPC) and immature reticulocyte fraction (IRF) counts provided by a routine automated blood counter as potential parameters for predicting the appropriate time for harvesting. The HPC and IRF values were compared with white blood cell (WBC) and CD34+ cell counts obtained by flow cytometry in 30 adult patients with hematological malignancies undergoing PBSC mobilization. It was observed that there was a significant correlation between HPC counts and CD34(+) cells in peripheral blood counts (r=0.61, P=0.0003) and between the number of HPC and CD34+cells collected by leukapheresis (r=0.5733, P=0.0009). Comparing HPC, IRF, WBC, and CD34+ cells parameters as a sign of hematological recovery showed that the raise in immature reticulocytes counts preceded the increase of WBC (P=0.0002), HPC (P=0.0001), and CD34(+) (P=0.0001) cells in peripheral blood counts. According to our results, HPC and IRF parameters may be integrated into clinical protocols to evaluate the timing of leukapheresis. IRF, as previously demonstrated in bone marrow transplantation, is the earliest sign of hematopoietic recovery in mobilization process.