[1427] Limited Flow Cytometry Panels in the Evaluation of Bone Marrow Samples

Douglas G Hoffmann, Burton H Kim. Wellstar Health System, Marietta, GA

Background: A comparison of limited and unlimited flow cytometry panels of bone marrow aspirate samples has not been reported. In this study, we compare a limited flow cytometry strategy (LS) to a broad multi-marker panel (MMS) on bone marrow samples to determine whether the use of limited panels impacts disease detection in these samples.
Design: We reviewed bone marrow morphology and flow cytometry of 1246 consecutive bone marrow samples received from August 2009 to December, 2010. One facility received 488 samples where an MMS strategy was employed. At a second hospital, 758 bone marrow samples were examined using an LS strategy.

Flow cytometry panel antibodies

Tube 1	Kappa	Lambda	CD5	CD10	CD20
Tube 2	HLA-DR	CD33	CD117	CD34	CD11b
Tube 3	CD16	CD64	CD14	CD13	CD11c
Tube 4	CD7	CD4	CD3	CD2	CD8
Tube 5	CD56	CD10	CD19	CD34	CD38
Tube 6	Kappa	Lambda	CD5	CD23	CD19
Tube 7	Kappa	Lambda	CD20	CD10	CD38

Limited panel consists of either tubes 1&4 or 6&7 only. Full panel is tubes 1-5. CD45 vs SSC used in all tubes.




Results: The percent of cases positive for neoplasia by flow cytometry using an LS strategy or a MMS strategy was similar (26.7% vs 22.0%). Overall disease detection by both morphology and flow cytometry was 37.9% (LS) versus 28.7% (MMS). The average number of flow cytometry markers used per bone marrow sample was statistically significant, 11.6 (LS) versus 22 (MMS) (p<.0001). The limited flow cytometry strategy was not associated with an increase in immunohistochemical stains (0.15 per case (LS) vs 0.23 per case (MMS)).

COMPARISON OF LIMITED FLOW CYTOMETRY PANEL STRATEGY WITH A MULTI-MARKER STRATEGY

	Limited Panel Strategy	Multi-marker Strategy
Number of cases	758	488
% Male	45.3	50.7
% Female	54.7	49.3
Average number of flow markers per case	11.6	22
% positive cases by flow	26.7	22
% positive cases by flow or histology	37.9	28.7
number of IHC stains per case	0.15	0.23

Conclusions: The use of a limited flow cytometry marker strategy does not result in lower disease detection in bone marrow samples. Indeed, a limited marker strategy not only results in a similar disease detection rate when compared to a multi-marker strategy, but also reduces the average number of flow cytometry markers used per case by almost 50%.
Category: Hematopathology

Wednesday, March 21, 2012 1:00 PM

Poster Session VI # 245, Wednesday Afternoon