[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 1KappaLambdaCD5CD10CD20
Tube 2HLA-DRCD33CD117CD34CD11b
Tube 3CD16CD64CD14CD13CD11c
Tube 5CD56CD10CD19CD34CD38
Tube 6KappaLambdaCD5CD23CD19
Tube 7KappaLambdaCD20CD10CD38
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)).

 Limited Panel StrategyMulti-marker Strategy
Number of cases758488
% Male45.350.7
% Female54.749.3
Average number of flow markers per case11.622
% positive cases by flow26.722
% positive cases by flow or histology37.928.7
number of IHC stains per case0.150.23

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


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