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Peripheral blood cytogenetic studies in hematological neoplasms: predictors of obtaining metaphases for analysis
Author(s) -
Hussein Kebede,
Ketterling Rhett P.,
Hulshizer Rachael L.,
Kuffel Daniel G.,
Wiktor Anne E.,
Hanson Curtis A.,
Tefferi Ayalew,
Van Dyke Daniel L.
Publication year - 2008
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2007.01021.x
Subject(s) - leukocytosis , myeloid , medicine , myelofibrosis , bone marrow , cytopenia , myeloproliferative neoplasm , pathology , immunophenotyping , univariate analysis , gastroenterology , cytogenetics , hematology , immunology , biology , flow cytometry , biochemistry , multivariate analysis , chromosome , gene
Peripheral blood (PB) is sometimes used in place of bone marrow (BM) for cytogenetic studies during the evaluation of hematologic malignancies. A total of 242 PB cytogenetic studies from adult patients were performed: clinical diagnosis was a myeloid neoplasm in 169 patients (70%), lymphoid or plasma cell neoplasm in 50 (21%), and a benign/reactive cytopenia or leukocytosis in 23 (9%). PB cytogenetic studies resulted in at least two analyzable metaphases in 142 of the 242 study cases (59%); in univariate analysis, this was predicted by the specific clinical diagnosis ( P < 0.0001), presence and degree of circulating myeloid progenitor cells or blasts of any lineage ( P < 0.0001), higher leukocyte count ( P < 0.001), lower platelet count ( P = 0.003), lower hemoglobin level ( P = 0.002), and presence of palpable splenomegaly ( P = 0.002). In multivariable analysis, only the presence of circulating myeloid progenitor cells or blasts sustained significance and this was consistent with the high yield rates seen in primary myelofibrosis (PMF) (80%), post‐PV/ET PMF (85%), acute myeloid leukemia (76%), and acute lymphoblastic leukemia (80%) in contrast with the low rates seen in ET (0%) and PV (2%). In 104 cases, BM cytogenetic studies were performed within 1 month of the PB cytogenetic studies; an abnormal BM cytogenetic finding was another independent predictor of a successful PB study ( P = 0.002). PB cytogenetic studies are most appropriate in diseases of adults characterized by presence of circulating myeloid progenitors or blasts; the yield otherwise is too small to be cost‐effective.