Diagnostic significance of cerebrospinal fluid flow cytometry in Chinese children with B lineage acute lymphoblastic leukemia
Abstract Background Central nervous system leukemia (CNSL) is one of the major causes of the poor prognosis of childhood leukemia. We aimed to compare the sensitivity of cytomorphology (CM) and flow cytometry (FCM) in diagnosing CNSL, emphasizing the importance of FCM in the diagnosis process. Metho...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-024-04684-4 |
| _version_ | 1797246972100345856 |
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| author | Xue Tang Huirong Mai Lulu Wang Shiyang Chen Fen Chen Tonghui Li Yi Liu Guichi Zhou Shilin Liu Ying Wang Sixi Liu Xiaoying Fu Feiqiu Wen |
| author_facet | Xue Tang Huirong Mai Lulu Wang Shiyang Chen Fen Chen Tonghui Li Yi Liu Guichi Zhou Shilin Liu Ying Wang Sixi Liu Xiaoying Fu Feiqiu Wen |
| author_sort | Xue Tang |
| collection | DOAJ |
| description | Abstract Background Central nervous system leukemia (CNSL) is one of the major causes of the poor prognosis of childhood leukemia. We aimed to compare the sensitivity of cytomorphology (CM) and flow cytometry (FCM) in diagnosing CNSL, emphasizing the importance of FCM in the diagnosis process. Methods One-hundred-sixty-five children with newly diagnosed B-cell Acute Lymphoblastic Leukemia (B-cell ALL) were included in this study. Cerebrospinal fluid (CSF) samples were taken for routine CSF analysis, CM analysis, and FCM examination. Computed tomography scans and/or magnetic resonance imaging were performed at diagnosis. Patients with CNS2, CNS3, and traumatic lumbar puncture (TLP) at diagnosis received two additional courses of triple intrathecal injections during induction treatment. We compared the sensitivity of FCM and CM in the diagnosis of children with CNSL. Results One hundred and twenty-eight (77.58%) CSF samples were negative by either CM or FCM (CM−/FCM−), four (2.42%) were positive by both CM and FCM (CM+/FCM+), and thirty-three (20%) displayed a single positive finding by FCM (CM−/FCM+) (p = 0.044). By adding two intrathecal injections in the induction treatment, ten children with TLP+ had no CNS relapse, like those with TLP−. However, compared to CNS1 and TLP, the event-free survival (EFS) did not significantly improve in patients with CNS2 and CNS3. Moreover, CNSL status was associated with worse 3-year EFS (p < 0.05). Conclusions We have validated that FCM is more accurate in stratifying the status of the CNS compared to CM analysis. However, to improve the EFS rate of childhood leukemia, it is necessary to combine CM examination, FCM, and cranial imaging for the early diagnosis of CNSL. |
| first_indexed | 2024-04-24T19:51:17Z |
| format | Article |
| id | doaj.art-041eeb2cef57405292ffff77f34ee767 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-04-24T19:51:17Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-041eeb2cef57405292ffff77f34ee7672024-03-24T12:34:10ZengBMCBMC Pediatrics1471-24312024-03-012411810.1186/s12887-024-04684-4Diagnostic significance of cerebrospinal fluid flow cytometry in Chinese children with B lineage acute lymphoblastic leukemiaXue Tang0Huirong Mai1Lulu Wang2Shiyang Chen3Fen Chen4Tonghui Li5Yi Liu6Guichi Zhou7Shilin Liu8Ying Wang9Sixi Liu10Xiaoying Fu11Feiqiu Wen12Department of Hematology and Oncology, Shenzhen Children’s HospitalDepartment of Hematology and Oncology, Shenzhen Children’s HospitalDepartment of Hematology and Oncology, Shenzhen Children’s HospitalDepartment of Laboratory Medicine, Shenzhen Children’s HospitalDepartment of Hematology and Oncology, Shenzhen Children’s HospitalDepartment of Hematology and Oncology, Shenzhen Children’s HospitalDepartment of Hematology and Oncology, Shenzhen Children’s HospitalDepartment of Hematology and Oncology, Shenzhen Children’s HospitalDepartment of Hematology and Oncology, Shenzhen Children’s HospitalDepartment of Hematology and Oncology, Shenzhen Children’s HospitalDepartment of Hematology and Oncology, Shenzhen Children’s HospitalDepartment of Laboratory Medicine, Shenzhen Children’s HospitalDepartment of Hematology and Oncology, Shenzhen Children’s HospitalAbstract Background Central nervous system leukemia (CNSL) is one of the major causes of the poor prognosis of childhood leukemia. We aimed to compare the sensitivity of cytomorphology (CM) and flow cytometry (FCM) in diagnosing CNSL, emphasizing the importance of FCM in the diagnosis process. Methods One-hundred-sixty-five children with newly diagnosed B-cell Acute Lymphoblastic Leukemia (B-cell ALL) were included in this study. Cerebrospinal fluid (CSF) samples were taken for routine CSF analysis, CM analysis, and FCM examination. Computed tomography scans and/or magnetic resonance imaging were performed at diagnosis. Patients with CNS2, CNS3, and traumatic lumbar puncture (TLP) at diagnosis received two additional courses of triple intrathecal injections during induction treatment. We compared the sensitivity of FCM and CM in the diagnosis of children with CNSL. Results One hundred and twenty-eight (77.58%) CSF samples were negative by either CM or FCM (CM−/FCM−), four (2.42%) were positive by both CM and FCM (CM+/FCM+), and thirty-three (20%) displayed a single positive finding by FCM (CM−/FCM+) (p = 0.044). By adding two intrathecal injections in the induction treatment, ten children with TLP+ had no CNS relapse, like those with TLP−. However, compared to CNS1 and TLP, the event-free survival (EFS) did not significantly improve in patients with CNS2 and CNS3. Moreover, CNSL status was associated with worse 3-year EFS (p < 0.05). Conclusions We have validated that FCM is more accurate in stratifying the status of the CNS compared to CM analysis. However, to improve the EFS rate of childhood leukemia, it is necessary to combine CM examination, FCM, and cranial imaging for the early diagnosis of CNSL.https://doi.org/10.1186/s12887-024-04684-4Central nervous systemCytomorphologyFlow cytometryAcute lymphoblastic leukemia |
| spellingShingle | Xue Tang Huirong Mai Lulu Wang Shiyang Chen Fen Chen Tonghui Li Yi Liu Guichi Zhou Shilin Liu Ying Wang Sixi Liu Xiaoying Fu Feiqiu Wen Diagnostic significance of cerebrospinal fluid flow cytometry in Chinese children with B lineage acute lymphoblastic leukemia BMC Pediatrics Central nervous system Cytomorphology Flow cytometry Acute lymphoblastic leukemia |
| title | Diagnostic significance of cerebrospinal fluid flow cytometry in Chinese children with B lineage acute lymphoblastic leukemia |
| title_full | Diagnostic significance of cerebrospinal fluid flow cytometry in Chinese children with B lineage acute lymphoblastic leukemia |
| title_fullStr | Diagnostic significance of cerebrospinal fluid flow cytometry in Chinese children with B lineage acute lymphoblastic leukemia |
| title_full_unstemmed | Diagnostic significance of cerebrospinal fluid flow cytometry in Chinese children with B lineage acute lymphoblastic leukemia |
| title_short | Diagnostic significance of cerebrospinal fluid flow cytometry in Chinese children with B lineage acute lymphoblastic leukemia |
| title_sort | diagnostic significance of cerebrospinal fluid flow cytometry in chinese children with b lineage acute lymphoblastic leukemia |
| topic | Central nervous system Cytomorphology Flow cytometry Acute lymphoblastic leukemia |
| url | https://doi.org/10.1186/s12887-024-04684-4 |
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