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Test ID: HLLFH    
Hematologic Disorders, Leukemia/Lymphoma; Flow Hold Varies

Useful For Suggests clinical disorders or settings where the test may be helpful

Evaluating lymphocytoses of undetermined etiology

 

Identifying B- and T-cell lymphoproliferative disorders involving blood and bone marrow

 

Distinguishing acute lymphoblastic leukemia (ALL) from acute myeloid leukemia (AML)

 

Immunologic subtyping of ALL

 

Distinguishing reactive lymphocytes and lymphoid hyperplasia from malignant lymphoma

 

Distinguishing between malignant lymphoma and acute leukemia

 

Phenotypic subclassification of B- and T-cell chronic lymphoproliferative disorders, including chronic lymphocytic leukemia, mantle cell lymphoma, and hairy cell leukemia

 

Recognizing AML with minimal morphologic or cytochemical evidence of differentiation

 

Recognizing monoclonal plasma cells

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Diagnostic hematopathology has become an increasingly complex subspecialty, particularly with neoplastic disorders of blood and bone marrow. While morphologic assessment of blood smears, bone marrow smears, and tissue sections remains the cornerstone of lymphoma and leukemia diagnosis and classification, immunophenotyping is a very valuable and important complementary tool.

 

Immunophenotyping hematopoietic specimens can help resolve many differential diagnostic problems posed by the clinical or morphologic features.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

When performed, an interpretive report will be provided.

This test will be processed as a laboratory consultation. An interpretation of the immunophenotypic findings and correlation with the morphologic features will be provided by a hematopathologist.

Interpretation Provides information to assist in interpretation of the test results

Report will include a morphologic description, a summary of the procedure, the percent positivity of selected antigens, and an interpretive conclusion based on the correlation of the clinical history with the morphologic features and immunophenotypic results.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Specimens will be initially triaged to determine which, if any, of the immunophenotyping panels should be performed.

Clinical Reference Provides recommendations for further in-depth reading of a clinical nature

1. Hanson CA, Kurtin PJ, Katzman JA, et al: Immunophenotypic analysis of peripheral blood and bone marrow in the staging of B-cell malignant lymphoma. Blood 1999;94:3889-3896

2. Hanson CA: Acute leukemias and myelodysplastic syndromes. In Clinical Laboratory Medicine. Edited by KD McClatchey. Baltimore, MD, Williams and Wilkins, Inc, 1994, pp 939-969

3. Morice WG, Leibson PJ, Tefferi A: Natural killer cells and the syndrome of chronic natural killer cell lymphocytosis. Leuk Lymphoma 2001;41(3-4):277-284

4. Langerak AW, van Den Beemd R, Wolvers-Tettero IL, et al: Molecular and flow cytometric analysis of the Vbeta repertoire for clonality assessment in mature TCR alpha beta T-cell proliferations. Blood 2001;98(1):165-173

5. Hoffman RA, Kung PC, Hansen QP, Goldstein G: Simple and rapid measurement of T-lymphocytes and their subclass in peripheral blood. Proc Natl Acad Sci USA 1980;77:4914-4917

6. Jaffe ES, Cossman J: Immunodiagnosis of lymphoid and mononuclear phagocytic neoplasms. In Manual of Clinical Immunology. Third edition. Edited by NR Rose, H Friedman, JL Fahey JL. ASM Press, 1987, pp 779-790

7. Morice WG, Kimlinger T, Katzmann JA, et al: Flow cytometric assessment of TCR-V-beta expression in the evaluation of peripheral blood involvement by T-cell lymphoproliferative disorders: a comparison with conventional T-cell immunophenotyping and molecular genetic techniques. Am J Clin Pathol 2004;121(3):373-383

8. Stelzer GT, Shultz KE, Loken MR: CD45 gating for routine flow cytometric analysis of bone marrow specimens. Ann NY Acad Sci 1993;677:265-280

Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test