Multicolor flow cytometry on pericardial effusion for a prompt diagnosis and treatment of hematological malignancies with heart involvement
BackgroundMalignancies represent 15–50% of total causes of pericardial effusions (PE). Routine analyses recommended to be performed on pericardial fluid include general chemistry, cytology, polymerase chain reaction, and microbiological cultures. Multicolor flow cytometry (FC) is a laboratory test t...
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| Format: | Article |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1000259/full |
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| author | Luigi Cappannoli Luigi Cappannoli Massimo Imazio Stefan Hohaus Stefan Hohaus Gianluigi Saponara Domenico D’Amario Domenico D’Amario Silvia Bellesi Elena Maiolo Marcello Viscovo Federica Fatone Eleonora Alma Francesco D’Alò Francesco D’Alò Filippo Crea Filippo Crea Tommaso Sanna Tommaso Sanna |
| author_facet | Luigi Cappannoli Luigi Cappannoli Massimo Imazio Stefan Hohaus Stefan Hohaus Gianluigi Saponara Domenico D’Amario Domenico D’Amario Silvia Bellesi Elena Maiolo Marcello Viscovo Federica Fatone Eleonora Alma Francesco D’Alò Francesco D’Alò Filippo Crea Filippo Crea Tommaso Sanna Tommaso Sanna |
| author_sort | Luigi Cappannoli |
| collection | DOAJ |
| description | BackgroundMalignancies represent 15–50% of total causes of pericardial effusions (PE). Routine analyses recommended to be performed on pericardial fluid include general chemistry, cytology, polymerase chain reaction, and microbiological cultures. Multicolor flow cytometry (FC) is a laboratory test that already proved to be useful in the detection of lymphoproliferative and metastatic malignancies in pleural and peritoneal effusions, but current guidelines do not mention its use on PE to reach a diagnosis.MethodsOur institutional protocol foresees to routinely perform a multicolor FC analysis on pericardial fluid samples obtained by pericardiocentesis, in addition to other guidelines-recommended analyses. A sample of 15–30 ml is analyzed using a lyse and wash staining method using combination panels of antibodies, allowing to detect specific cellular subpopulations, analyzing tens to hundreds of thousands of cells in few seconds. The present manuscript aims to report our single-center experience with this diagnostic tool in patients presenting with PE requiring pericardiocentesis.ResultsRoutine use of multicolor FC on pericardial fluid samples in our institution allowed to reach a definite diagnosis of cardiac lymphomas in two patients presenting with otherwise unexplained severe PE. This resulted in immediate start of combined immunotherapy, with patients’ clinical improvement. At 6 months follow-up both patients are alive and presented a complete disease regression.ConclusionPreliminary evidence from routine use of multicolor FC on PE support that this is a promising tool to reach a rapid diagnosis of hematological malignancies with heart involvement, leading to a prompt initiation of targeted therapies. |
| first_indexed | 2024-04-11T07:01:13Z |
| format | Article |
| id | doaj.art-7b52700064624a6da95979293d1fb049 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-11T07:01:13Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-7b52700064624a6da95979293d1fb0492022-12-22T04:38:42ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-11-01910.3389/fcvm.2022.10002591000259Multicolor flow cytometry on pericardial effusion for a prompt diagnosis and treatment of hematological malignancies with heart involvementLuigi Cappannoli0Luigi Cappannoli1Massimo Imazio2Stefan Hohaus3Stefan Hohaus4Gianluigi Saponara5Domenico D’Amario6Domenico D’Amario7Silvia Bellesi8Elena Maiolo9Marcello Viscovo10Federica Fatone11Eleonora Alma12Francesco D’Alò13Francesco D’Alò14Filippo Crea15Filippo Crea16Tommaso Sanna17Tommaso Sanna18Department of Cardiovascular Sciences, Catholic University of the Sacred Heart (UCSC), Rome, ItalyDepartment of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyCardiology, Department of Cardiothoracic, University Hospital “Santa Maria della Misericordia”, ASUFC, Udine, ItalyDepartment of Imaging Diagnostic, Radiotherapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyDepartment of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyDepartment of Cardiovascular Sciences, Catholic University of the Sacred Heart (UCSC), Rome, ItalyDepartment of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyDepartment of Imaging Diagnostic, Radiotherapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyDepartment of Imaging Diagnostic, Radiotherapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyDepartment of Imaging Diagnostic, Radiotherapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyDepartment of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Imaging Diagnostic, Radiotherapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyDepartment of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Cardiovascular Sciences, Catholic University of the Sacred Heart (UCSC), Rome, ItalyDepartment of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyDepartment of Cardiovascular Sciences, Catholic University of the Sacred Heart (UCSC), Rome, ItalyDepartment of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyBackgroundMalignancies represent 15–50% of total causes of pericardial effusions (PE). Routine analyses recommended to be performed on pericardial fluid include general chemistry, cytology, polymerase chain reaction, and microbiological cultures. Multicolor flow cytometry (FC) is a laboratory test that already proved to be useful in the detection of lymphoproliferative and metastatic malignancies in pleural and peritoneal effusions, but current guidelines do not mention its use on PE to reach a diagnosis.MethodsOur institutional protocol foresees to routinely perform a multicolor FC analysis on pericardial fluid samples obtained by pericardiocentesis, in addition to other guidelines-recommended analyses. A sample of 15–30 ml is analyzed using a lyse and wash staining method using combination panels of antibodies, allowing to detect specific cellular subpopulations, analyzing tens to hundreds of thousands of cells in few seconds. The present manuscript aims to report our single-center experience with this diagnostic tool in patients presenting with PE requiring pericardiocentesis.ResultsRoutine use of multicolor FC on pericardial fluid samples in our institution allowed to reach a definite diagnosis of cardiac lymphomas in two patients presenting with otherwise unexplained severe PE. This resulted in immediate start of combined immunotherapy, with patients’ clinical improvement. At 6 months follow-up both patients are alive and presented a complete disease regression.ConclusionPreliminary evidence from routine use of multicolor FC on PE support that this is a promising tool to reach a rapid diagnosis of hematological malignancies with heart involvement, leading to a prompt initiation of targeted therapies.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1000259/fullpericardial effusionflow cytometry—methodsmalignanciesheart failurecardiac lymphomaguidelines |
| spellingShingle | Luigi Cappannoli Luigi Cappannoli Massimo Imazio Stefan Hohaus Stefan Hohaus Gianluigi Saponara Domenico D’Amario Domenico D’Amario Silvia Bellesi Elena Maiolo Marcello Viscovo Federica Fatone Eleonora Alma Francesco D’Alò Francesco D’Alò Filippo Crea Filippo Crea Tommaso Sanna Tommaso Sanna Multicolor flow cytometry on pericardial effusion for a prompt diagnosis and treatment of hematological malignancies with heart involvement Frontiers in Cardiovascular Medicine pericardial effusion flow cytometry—methods malignancies heart failure cardiac lymphoma guidelines |
| title | Multicolor flow cytometry on pericardial effusion for a prompt diagnosis and treatment of hematological malignancies with heart involvement |
| title_full | Multicolor flow cytometry on pericardial effusion for a prompt diagnosis and treatment of hematological malignancies with heart involvement |
| title_fullStr | Multicolor flow cytometry on pericardial effusion for a prompt diagnosis and treatment of hematological malignancies with heart involvement |
| title_full_unstemmed | Multicolor flow cytometry on pericardial effusion for a prompt diagnosis and treatment of hematological malignancies with heart involvement |
| title_short | Multicolor flow cytometry on pericardial effusion for a prompt diagnosis and treatment of hematological malignancies with heart involvement |
| title_sort | multicolor flow cytometry on pericardial effusion for a prompt diagnosis and treatment of hematological malignancies with heart involvement |
| topic | pericardial effusion flow cytometry—methods malignancies heart failure cardiac lymphoma guidelines |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1000259/full |
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