Leukemia/Lymphoma Phenotyping Evaluation by Flow Cytometry

See Related Tests for tests associated with the following:

  • Acute leukemia diagnosis
  • Follicular, Burkitt, or diffuse large B-cell lymphoma diagnosis
  • Mantle cell lymphoma diagnosis
  • Chronic lymphocytic leukemia prognostication
  • Hairy cell leukemia diagnosis

Leukemia and lymphoma analysis by flow cytometry aids in identifying the tumor lineage, which in most cases is identified as T cell, B cell, or myeloid. Lineage identification can provide a confirmatory diagnosis or differential diagnosis, prognosis, and treatment options.

Disease Overview

Diagnosis/Treatment Issues

  • Phenotyping by flow cytometry can aid in evaluation of hematopoietic neoplasms
    • Specimens include bone marrow, whole blood, tissue, or fluid
  • Phenotyping may aid in monitoring response to therapy in individuals with an established diagnosis of hematopoietic neoplasms

Test Interpretation

  • Markers analyzed as needed, based on clinical evidence, to fully characterize any abnormalities identified by the screening panel.
    • Additional markers selected based on pathologist interpretation of the screening panel results.
  • Antigens included:
    • T cell: CD1a, CD2, CD3, CD4, CD5, CD7, CD8, TCR γ-δ, cytoplasmic CD3
    • B cell: CD10, CD19, CD20, CD22, CD23, CD103, CD200, kappa, lambda,  cytoplasmic kappa, cytoplasmic lambda
    • Myeloid/monocyte: CD11b, CD13, CD14 (Mo2), CD14 (MY4), CD15, CD33, CD64, CD117, myeloperoxidase
  • Miscellaneous: CD11c, CD16, CD25, CD30, CD34, CD38, CD41, CD42b, CD45, CD56, CD57, CD61, HLA-DR, glycophorin, TdT, bcl-2, ALK-1, CD123, CD138, CD200, CD26, CD45, CRLF-2

Clinical Sensitivity

Limit of detection is 0.01-1.0% depending on phenotype and disease.

Results

  • Antigens will be reported as positive or negative.
  • Interpretive comments that further characterize intensity patterns are included.
    • Dim, bright, variable, or partial may be reported.
  • Light-chain expression may be reported as polytypic/polyclonal or restricted/monotypic/monoclonal.
    • May include kappa/lambda ratio.
  • Pattern of CD antigen testing will be interpreted with recommendations for further testing, if indicated.

Limitations

  • Some hematopoietic neoplasms do not show phenotypic abnormalities, and may not be detected by flow cytometry.
  • Poor cell viability may adversely affect antigens and impede the ability to properly identify neoplastic cells.
  • Flow results cannot be used alone to diagnose malignancy.
    • Results should be interpreted in conjunction with morphology, clinical information, and other necessary ancillary tests for a definitive diagnosis.

Acute leukemia diagnosis

Follicular, Burkitt, or diffuse large B-cell lymphoma diagnosis

Mantle cell lymphoma diagnosis

Chronic lymphocytic leukemia prognostication

Hairy cell leukemia diagnosis

Last Update: August 2019