Concordance study between conventional cytology (CC) and flow cytometry (FCM) in identifying neoplastic infiltration of the cerebrospinal fluid (CSF) in patients with acute leukemia (AL).
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Introduction: Acute leukemia is the most common childhood cancer. The clinical manifestations are systemic and infiltration to central nervous system (CNS) is uncommon and impact on the treatment and prognosis; as CMF different techniques and CC have been implemented in order to improve efficiency in diagnosing CSF blasts. (1, 2,3) Methods: Retrospective study of agreement between the CPM and CC to determine the presence of blasts in the CSF in pediatric patients with a diagnosis of LA. an analysis of the variables of interest was performed and the correlation was calculated using the Kappa value. Results:
111 samples from 34 patients, of whom only 6 were low risk (17.6%) were analyzed. The presence of alterations in the cytogenetic studies was low, only 2 patients (5.9%).
Of the 111 samples found only 37 concurrent CC and CPM report, most of these had no CNS involvement, CC was positive in 6 patients (5.5%) and CMF were positive in 16 patients (14.5%).
The agreement between the 2 techniques was satisfactory only when the 2 tests were negative kappa (0.80 to 0.96) Conclusions: The diagnosis of CNS infiltration should be optimized; and today we have 2 techniques (CC and CMF) of different operating characteristics.
Although the CPM is reported as a more sensitive method has higher costs and work only good agreement was shown by the CC when it is negative, the above further studies are needed to determine whether despite increasing costs should switch to the cytology is currently the gold standard.
cytology, cytometry, leukemia, central nervous systemcitología, citometría, leucemia
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