Background & objective: Lymphocytic leukemia and bone marrow involvement of non-Hodgkin's lymphoma (NHL) can be diagnosed by bone marrow morphology or lymph node biopsy combined with bone marrow examination. The data of original and differentiation status of tumor can be analyzed by immunophenotype of bone marrow. These are necessary for diagnosis and treatment of lymphocytic malignancy. This study was designed to investigate the value of multiparameter flow cytometry in diagnosis of leukemia and bone marrow involvement of NHL.
Methods: The samples from 11 cases of untreated leukemia bone marrow and 41 cases of untreated NHL with bone marrow involvement and 2 cases of bone marrow whose biopsy could not be obtained due to huge mass in mediastinum and abdomen were detected by multiparameter flow cytometry using antibodies of T, B, Myeloid cell series. Three-color staining was done by CD45 combined with two cell series or special phase antibodies. Using CD45/SSC set gate to identify blast cells from mature cells. The samples were analyzed using five parameters [forward scatter (FSC), side scatter(SSC), McAb1-FITC, McAb2-PE, and CD45-cychrome].
Results: Immunophenotype and diagnosis of 11 cases of leukemia were further confirmed by flow cytometry (FCM). Of 41 cases of NHL with bone marrow involvement, 33 cases (80.5%) lymph nodes immunophenotype by pathology diagnosis were consistent with bone marrow immunophenotype by FCM, 8 cases (19.5%) were inconsistent, but right diagnosis were made by combining with clinical presentation, pathology, bone marrow morphology and FCM. Another 2 cases with huge mediastinal mass and abdominal mass were diagnosed as T-NHL and B-NHL by bone marrow morphology and FCM without lymph node biopsy.
Conclusion: Multiparameter flow cytometry of bone marrow can further ascertain the diagnosis of leukemia and NHL with bone marrow involvement. It also gives us data of cells lineage and differentiation status for leukemia and NHL. It is helpful for diagnosis, differential diagnosis, and treatment.