Haema 2013; 4(2):117-127
by George Paterakis
Immunology Department-Flow Cytometry Laboratory, “G. Gennimata” General Hospital, Athens, Greece
Abstract
Flow cytometry immunophenotyping of blood and marrow aspirate fluid specimens is included as a rule in the initial diagnostic work-up of B chronic lymphoproliferative disorders (BCLPD). Along with morphology and the clinical presentation it forms the basis for differential diagnosis in most cases. It appears to be the method of choice for assessing clonality. Following this, selected antibody combinations are applied in order to discriminate the various BCLPD. Even if the phenotype is not al- ways specific to formulate a definite diagnosis, it appears to be helpful for the initial diagnostic assessment and patient management. Immunophenotype per se should not be considered without also taking into account classic smear morphology and the clinical presentation. Identical protocols to those applied in blood and marrow fluid can be used in cell suspensions from lymphoid tissues or fine needle aspirates. Recently, small monoclonal populations of B cells of uncertain clinical significance were recognized, defined as monoclonal B lymphocytosis (MBL). MBL should be differentiated from lymphomas. Complete treatment response has been recently revisited by minimal residual disease flow cytometry data in chronic lymphocytic leukemia and other BCLPD.