Startseite Development of an algorithm for the identification of leukemic hematolymphoid neoplasms in Primary Care patients
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Development of an algorithm for the identification of leukemic hematolymphoid neoplasms in Primary Care patients

  • Covadonga Quirós ORCID logo , Ariana Fonseca , Sara Alonso-Álvarez , Marco Antonio Moro-García , Rebeca Alonso-Arias , Lucía-Rita Morais , Francisco V. Álvarez-Menendez und Enrique Colado ORCID logo EMAIL logo
Veröffentlicht/Copyright: 9. April 2020
Diagnosis
Aus der Zeitschrift Diagnosis Band 8 Heft 2

Abstract

Background

Diagnosis of hematolymphoid neoplasm (HLN) requires different technologies which are performed on a patient basis instead of per protocol. We hypothesize that integration of hematimetric and cytological analysis along with multiparametric flow cytometry (MFC) provides a framework to evaluate peripheral blood (PB) samples from Primary Care.

Methods

Samples from patients with persistent (>3 months) lymphocytosis (>5 × 109/L) and/or monocytosis (>109/L) or the presence of atypical and/or blast cells upon the smear review were analyzed by MFC concurrent to cytological analysis. MFC studies were carried out following standardized procedures.

Results

In a 3-year period, smear review and MFC were performed simultaneously in 350 samples, demonstrating HLN in 194 cases (55.4%). In 156 cases, reactive cell populations were found. The combination of age, absolute lymphocyte count (ALC), hemoglobin and platelets provided the best correlation with MFC for the presence of a chronic lymphoproliferative disorder (CLPD) in lymphocytosis [area under the curve (AUC) 0.891, p < 0.05]. A model evaluating the probability of CLPD has been proposed and validated in an independent cohort.

Conclusions

A strategy to perform MFC studies following standardized procedures has proven to be useful to evaluate samples from patients in Primary Care centers for HLN diagnosis or reactive conditions, providing a sensitive and rapid clinical orientation and avoiding unnecessary consultations in routine clinical practice. The probability for the presence of CLPD in PB can be calculated and help guide decision-making regarding further testing.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/dx-2020-0021).


Received: 2020-02-04
Accepted: 2020-02-26
Published Online: 2020-04-09
Published in Print: 2021-05-26

©2020 Walter de Gruyter GmbH, Berlin/Boston

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