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Flow cytometry as a diagnostic tool in lymphomatous or leukemic meningitis†
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Article first published online: 24 OCT 2011
Copyright © 2011 American Cancer Society
Volume 118, Issue 7, pages 1747–1753, 1 April 2012
How to Cite
Ahluwalia, M. S., Wallace, P. K. and Peereboom, D. M. (2012), Flow cytometry as a diagnostic tool in lymphomatous or leukemic meningitis. Cancer, 118: 1747–1753. doi: 10.1002/cncr.26335
Editorial support was provided by Ann Yeung, PhD (Phase 5 Communications Inc, New York, NY).
- Issue published online: 19 MAR 2012
- Article first published online: 24 OCT 2011
- Manuscript Revised: 19 MAY 2011
- Manuscript Accepted: 19 MAY 2011
- Manuscript Received: 6 APR 2011
- flow cytometry;
- intrathecal chemotherapy
In patients with neoplastic meningitis (NM), early diagnosis is highly desirable because the rapid institution of intrathecal therapy may mitigate the course of the disease. Cytology, long considered the “gold standard” for diagnosis, has low sensitivity because of both the paucity of cells in the cerebrospinal fluid (CSF) and morphological similarities between benign and malignant cells. A comprehensive review of the literature from 2005 through 2011 was performed that focused on diagnostic modalities for lymphomatous meningitis. Several studies demonstrated the sensitivity of flow cytometry to be several-fold higher than that of cytology for the detection of CSF leukemia/lymphoma. Patients with negative cytology but positive flow cytometry results are often asymptomatic and have lower CSF cell counts and neoplastic B-cell percentages compared with patients with positive cytology findings. Flow cytometry is a highly sensitive technique capable of accurately detecting malignant cells, even in samples with very low cell counts. Flow cytometry allows for the earlier detection of NM before the onset of clinical symptoms and CSF pleocytosis and therefore may enable more effective treatment. Future consensus regarding standardized flow cytometric antibody panels, with uniform definitions of positivity, is likely to further advance the early detection of NM by flow cytometry and permit broader clinical applicability. Cancer 2012;. © 2011 American Cancer Society.