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High sensitivity of flow cytometry improves detection of occult leptomeningeal disease in acute lymphoblastic leukemia and lymphoblastic lymphoma

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Abstract

Conventional cytology (CC) of cerebrospinal fluid (CSF) fails to demonstrate malignant cells in up to 45 % of patients with acute lymphoblastic leukemia or lymphoblastic lymphoma (ALL/LL) in whom occult leptomeningeal disease is present. Flow cytometry (FCM) is considered more sensitive than CC, but clinical implications of CC negativity/CC positivity are not yet established. CSF samples from 38 adult patients with newly diagnosed ALL/LL were examined. Five (13 %) and nine (24 %) specimens were CC positive-FC positive (FCMpos/CCpos) and CC negative-FC positive (CCneg/FCMpos), respectively. The remaining 24 (63 %) samples were double negative (CCneg/FCMneg) (p = 0.001). CCneg/FCMpos patients showed a significantly shorter overall survival (OS) compared to CCneg/FCMneg ones. In multivariate analysis, the status of single FCM positivity was demonstrated to affect independently duration of OS (p = 0.005). In conclusion, FCM significantly improves detection of leptomeningeal occult localization in ALL/LL and appears to anticipate an adverse outcome. Further prospective studies on larger series are needed to confirm this preliminary observation.

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The authors declare no competing financial interests.

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Authors and Affiliations

  1. Cattedra di Ematologia, Dipartimento di Biopatologia e Prevenzione, Università Tor Vergata, Roma, Italia

    Maria Ilaria Del Principe, Francesco Buccisano, Mariagiovanna Cefalo, Luca Maurillo, Luigi Di Caprio, Fabio Di Piazza, Gottardo De Angelis, Maria Irno Consalvo, Daniela Fraboni, Giovanna De Santis, Concetta Ditto, Massimiliano Postorino, Giovanni Del Poeta, Sergio Amadori & Adriano Venditti

  2. Ematologia, Policlinico Universitario-Campus Biomedico, Roma, Italia

    Chiara Sarlo

  3. Istituto di Farmacologia Traslazionale, Dipartimento di Medicina, CNR, Roma, Italia

    Giuseppe Sconocchia

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  1. Maria Ilaria Del Principe
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  2. Francesco Buccisano
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  3. Mariagiovanna Cefalo
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  14. Giuseppe Sconocchia
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  15. Giovanni Del Poeta
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  16. Sergio Amadori
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Correspondence to Maria Ilaria Del Principe.

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Del Principe, M.I., Buccisano, F., Cefalo, M. et al. High sensitivity of flow cytometry improves detection of occult leptomeningeal disease in acute lymphoblastic leukemia and lymphoblastic lymphoma. Ann Hematol 93, 1509–1513 (2014). https://doi.org/10.1007/s00277-014-2080-6

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  • DOI: https://doi.org/10.1007/s00277-014-2080-6

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