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Immunophenotyping for Haematologists. Barbara J. Bain
Читать онлайн.Название Immunophenotyping for Haematologists
Год выпуска 0
isbn 9781119606154
Автор произведения Barbara J. Bain
Жанр Медицина
Издательство John Wiley & Sons Limited
Problems and Pitfalls
Clearly technical errors can lead to erroneous results of immunophenotyping. Rigorous quality control is required. Inappropriate selection of antibodies and erroneous interpretation can result from inadequate clinical information being provided or from failure to examine a film of the peripheral blood or bone marrow aspirate that is to be tested. Delays in transportation of a sample to the laboratory can lead to cell death and make testing of the sample unwise since results are likely to be misleading.
Errors in interpretation can occur if the results of immunophenotyping are not integrated with clinical, haematological, cytogenetic and genetic information. Not all cases of a specific condition will have a typical immunophenotype and, in some entities, the immunophenotype is not distinctive.
In certain circumstances flow cytometry of a bone marrow aspirate will show no abnormality despite a neoplastic infiltrate being present. This is likely to occur when there is diffuse or focal bone marrow fibrosis, when the aspirate is of low cellularity and when neoplastic cells are infrequent, fragile or dead. Findings are typically negative in Hodgkin lymphoma where the disease cells, Hodgkin and Reed–Sternberg cells, are present at a low frequency amongst a reactive environment of lymphocytes, plasma cells and eosinophils with associated reticulin fibrosis. In these circumstances it is trephine biopsy histology and immunohistochemistry that yield the diagnosis. It is therefore important not to exclude a diagnosis completely based solely on the results from one approach, particularly where the specimen quality is poor. No single investigation in isolation is infallible – by correlating the results of several investigations using different modalities, a unifying diagnosis can be achieved.
References
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2 2 Knight V (2019) The utility of flow cytometry for the diagnosis of primary immunodeficiencies. Int J Lab Haematol, 41, Suppl. S1, 63–72.
3 3 Ammann S, Lehmberg K, Zur Stadt U, Janka G, Rensing‐Ehl A, Klemann C et al. for HLH study of the GPOH (2017) Primary and secondary hemophagocytic lymphohistiocytosis have different patterns of T‐cell activation, differentiation and repertoire. Eur J Immunol, 47, 364–373.
4 4 Marsh RA and Haddad E (2018) How I treat primary haemophagocytic lymphohistiocytosis. Brit J Haematol, 182, 185–199.
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Bibliography
1 Béné MC (2019) The wonderful story of monoclonal antibodies. Int J Lab Hematol, 41, Suppl. S1, 8–14.
2 Gorczyca W (2017). Flow Cytometry in Neoplastic Hematology: Morphologic‐Immunophenotypic Correlation, 3rd edn. CRC Press, Boca Raton.
3 Leach M, Drummond M and Doig A (2013) Practical Flow Cytometry in Haematology Diagnosis. Wiley‐Blackwell, Oxford.
4 Ortolani C (2011) Flow Cytometry in Haematological Malignancies. Wiley‐Blackwell, Oxford.
5 Porwit A and Béné MC (2018) Multiparameter Flow Cytometry in the Diagnosis of Hematologic Malignancies. Cambridge University Press, Cambridge.
6 Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri S, Stein H and Thiele J (eds) (2017) WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, revised 4th edn. IARC Press, Lyon, pp. 37–38.
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