RE: Reporting clinical results

Hi Lydene, 

We always report a percentage of cells in each subset (lymphocytes, monocytes, granulocytes and abnormal cells) as a percentage of total nucleated cells. Therefore, the difference in results in the case like your can be easily explained to the hematologist. When the difference in % of abnormal cells is such remarkable like in erythroleukemia cases and obviously flow cytometry -based number is less accurate in this case (just because we loose some of these cells through lysis), we prefer to do an additional immunostain and report the % from morphological analysis and immunophenotype from flow.

Happy Holidays. Irina

Irina Grigorieva, PhD
Director, Flow Cytometry Laboratory
Northside Hospital, Atlanta, GA
(404)- 851-6541
e-mail: irina.grigorieva@northside.com




> -----Original Message-----
> From: Lydene McArthur [SMTP:Lydene.McArthur@cdhb.govt.nz]
> Sent: Thursday, December 14, 2006 9:29 PM
> To:	Cytometry Mailing List
> Subject:	Reporting clinical results
> 
> Hi everyone
>  
> I would like to get some feedback about reporting clinical flow cytometry results for bone marrow samples.  Does everyone report the percentage of abnormal and normal cell populations present.  If so, what value do you use to express the result - do you report each population as a percentage of CD45 positive cells, or as a percentage of total nucleated cells in the sample.
>  
> My reason for asking - we have a bone marrow sample from a patient with erythroleukaemia.	The morphology differential shows 89% erythroid precursors and 4% blasts.  The flow cytometry results show 20% erythroblasts (bright CD71/glycophorin A) and a smaller number of myeloblasts.  The percentage of erythroblasts between the two techniques is markedly different.	I have tried to explain to our Haematologist this is most likely due to the red cell lysing technique used to prepare the sample which can result in selective loss of red cell precursors (we are using ammonium chloride).  But I don't know whether he believes me!!   
>  
> Does anyone else have experience with flow cytometry analysis of erythroleukaemia?.  How do you report the results when the erythroid cell percentages are so different between the two techniques.  
>  
> Many thanks and christmas cheers (hic!)
>  
> Lydene McArthur
>  
> Haematology Surface Markers
> Canterbury Health Laboratories
> Christchurch
> New Zealand
> Phone +64 3 3640 917
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