From the Guidelines
To read a flow cytometry report, it is essential to focus on the interpretation section and review the percentages of different cell types, specific markers, and comments about clonality, as recommended by the most recent guidelines 1. When analyzing a flow cytometry report, the first step is to identify the patient information and the clinical question being addressed at the top of the report.
- The interpretation section provides the pathologist's conclusion about whether abnormal cell populations are present.
- The results section should be reviewed for the percentages of different cell types (like T cells, B cells, NK cells), noting any values outside the reference ranges.
- Specific markers (CD markers) that identify cell types and their expression patterns should be examined, as they are crucial in distinguishing between different cell populations.
- Comments about clonality should be looked for, as they may indicate malignancy, particularly in lymphoid disorders.
- Any scatter plots or histograms included in the report should be examined, where abnormal populations often appear as distinct clusters. The use of flow cytometry is highly recommended for diagnosing and monitoring various hematological disorders, including leukemias and lymphomas, as it can analyze thousands of cells simultaneously and identify abnormal populations even when they constitute a small percentage of the sample 1. In cases where the terminology or findings are unclear, it is advisable to consult with the ordering physician or pathologist for clarification of findings relevant to the clinical situation. The most recent guidelines emphasize the importance of using a comprehensive flow cytometry panel to distinguish between different types of acute leukemia, including AML and ALL 1. By following these steps and considering the recommendations from the most recent guidelines, healthcare professionals can effectively read and interpret flow cytometry reports to inform their clinical decisions.
From the Research
Understanding Flow Cytometry Reports
To read a flow cytometry report, it's essential to understand the basics of flow cytometry and its applications in diagnosing and monitoring various diseases, including leukemia [ 2, 3 ]. Flow cytometry is a technology that provides rapid multi-parametric analysis of single cells in solution [ 4 ].
Key Components of a Flow Cytometry Report
- Immunophenotyping: This involves the use of fluorochrome-conjugated antibodies to label cell-surface and intracellular proteins, allowing for the identification of specific cell populations [ 2 ].
- Data Analysis: The analysis of immunophenotypic data is crucial in diagnosing and monitoring diseases such as acute lymphoblastic leukemia [ 2, 3 ].
- Cell Surface Markers: The expression of specific cell surface markers, such as CD58, can be used to differentiate between different types of leukemia [ 5 ].
- Clinical Correlation: The correlation between immunophenotypic profiles and clinical findings, such as age, gender, and presence of tumor masses, is essential in understanding the disease prognosis [ 6 ].
Interpreting Flow Cytometry Results
- Identifying Cell Populations: Flow cytometry allows for the identification of specific cell populations based on their fluorescent or light scattering characteristics [ 4 ].
- Detecting Minimal Residual Disease: Flow cytometry can be used to detect minimal residual disease after therapy, which is a robust prognostic factor that may guide individualized treatment [ 2, 3 ].
- Differential Diagnosis: Flow cytometry can be used to differentiate between different types of leukemia, such as Burkitt lymphoma/leukemia and B-cell precursor acute lymphoblastic leukemia [ 5 ].