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2019, Number 4

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Rev Mex Patol Clin Med Lab 2019; 66 (4)

Concordance between morphological analysis and immunophenotype at the time of diagnosis and classification of acute leukemia in pediatric patients

Parra-Ortega, Israel; Núñez-Hernández Esmeralda;Nájera-Martínez Noemí;Mendoza-García Emma;Cortés-Flores Dolores Catalina;Gaytán-Morales Félix; Castorena-Villa Iván;López-Martínez Briceida

Language: Spanish
References: 50
Page: 193-211
PDF size: 374.25 Kb.


ABSTRACT

Introduction: On the diagnostic algorithm, the morphological evaluation of the bone marrow represents the first step in the diagnostic pathway and is the first tool to distinguish a leukemia, immunophenotyping allows confirming the lineage and subclassifying acute leukemias according to the degree of maturation. Material and methods: With the objective of comparing the morphological characterization versus immunophenotyping of bone marrow aspirates of pediatric patients, with suspected acute leukemia, through morphological evaluation and analysis cytometric flow multiparameter (CFM) to determine the degree of concordance that exists between both methods for the diagnosis and classification of acute leukemia, a total of 59 patients with clinical and laboratory suspicion of acute leukemia were included. Results: The percentage of agreement between both methods was 79.6% and the kappa index (κ) of 0.352. The correlation coefficient obtained by morphology and by CFM (52 samples) is R2 of 0.9406. Conclusions: It is necessary to perform the morphological analysis, before performing the immunophenotype to classify the specific lineage and the stage of differentiation of the leukemic cells, both studies are complementary and not exclusive. In cases of relapse, a new immunophenotype should always be performed considering the highest number of cell markers in the different hematopoietic lineages.


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