Flow cytometric leukemia and lymphoma analysis may aid in identifying the tumor lineage for diagnostic and prognostic purposes. After review of the clinical history and morphology, a panel of markers is selected for each case by a board-certified pathologist. In most cases, the lineage can be identified as T-cell, B-cell, or myeloid and a diagnosis or differential diagnosis can be made.
T-cell: CD2, CD3, CD4, CD5, CD7, CD8, Cytoplasmic CD3
B-cell: CD10, CD19, CD20, CD22, CD23, CD103, Kappa, Lambda, Cytoplasmic Kappa, Cytoplasmic Lambda
Myelo/Mono: CD11b, CD13, CD14, CD15, CD33, CD64, CD117, myeloperoxidase (MPO)
Misc: CD11c, CD16, CD25, CD34, CD36, CD38, CD41a, CD45, CD56, CD57, CD61, HLA-DR, TdT, CD138, CD45, CD79a.
*Not all markers will be reported in all cases. Requests for specific markers to be run must be listed on manual requisition or by footnote for electronic orders. We do not offer individual marker identification separately outside of the markers in this panel.
A comprehensive flow cytometric Leukemia/Lymphoma assessment of tissue, fluid, or peripheral blood typically includes 14 or more markers; a bone marrow evaluation typically includes 15 or more markers. At the discretion of the pathologist, limited-cellularity samples (CSF, tissue/fluids) will be triaged and an appropriate number of markers will be run due to the irreplaceable nature of these samples. Limited-cellularity samples typically include a minimum number of markers (e.g., 8-15 markers).
The report will include a pathologist interpretation and a marker interpretation range corresponding to CPT codes of 2-8 markers, 9-15 markers, and 16+ markers interpreted. Charges apply per marker.
Remarks: A minimum of 10,000 viable cells is required for flow cytometry phenotyping of samples containing a very limited number of markers (may also be called antibodies or antigens). For low-count specimens, supplying clinical and diagnostic
information is especially important to help ensure that the most appropriate marker combinations are evaluated before the specimen is depleted of cells.
Bone marrow or whole blood: Provide specimen source, CBC, Wright stained smear (if available), clinical history, differential diagnosis, and any relevant pathology reports.
Tissue or fluid: Provide specimen source, clinical history, differential diagnosis, and any relevant pathology reports.
Follow up: If previous leukemia/lymphoma phenotyping was performed at another lab, the outside flow cytometry report and histograms (if possible) should accompany the specimen.
Bone Marrow Requisitions and supplies including RPMI are available upon request.