文档介绍：流式细胞术在淋巴增殖性疾病中的应用
四川大学华西医院血液科
朱焕玲
WHO2008淋巴增殖性疾病分类(1)
Mature T and NK-cell neoplasms
T-PLL
T-LGL
Chronic LPD of NK cells(NK-LGL)
Aggressive NK cell leukemia
EBV+ T cell LPD of childhood
Systemic
Hydroa iniforme-like lymphoma.
Adult T cell leukemia/lymphoma
Extrampdal NK/T cell lymphoma, nasal type
WHO2008淋巴增殖性疾病分类(2)
Mature T and NK-cell neoplasms
Enteropathy-associatied T cell lymphoma
Hepatosplenic T cell lymphoma
SPTCL
Mycosis fungoides/Sezary syndrome
Primary cutaneous CD30+ T cell LPD
Primary cutaneous PTCL
PTCL, NOS
AITCL
ALCL, ALK+/ALK-
WHO2008淋巴增殖性疾病分类(3)
CLL/SLL
B-PLL
Splenic B-cell MZL
HCL
LPL
Heavy chain diseases
Plasma cell neoplasms
MALT Lymphoma
FL
MCL
DLBCL
Primary mediastinal LBCL
Intravascular LBCL
Plasmablastic lymphoma
Burkitt lymphoma
DLBCL/Burkitt
DLBCL/HL
Mature B cell neoplasms
2006 Bethesda 会议共识(1)
流式分析指征:sensitive screen
Cytopenias
Elevated leukocyte count
Lymphocytosis
Monocytosis
Eosiophilia
Aptypical cells or blasts in PB , BM, fluids
Plasmacytosis or monoclonal gammopathy;
Organomegaly and tissue masses
2006 Bethesda 会议共识(2)
Staging
Monitoring response
MRD
Documenting relapse or progression
Diagnosing intercurrent hematologic malignancy
Therapy related MDS
2006 Bethesda 会议共识(3)
Not indicated in following situations
Mature neutrophilia
Polyclonal hypergammaglobulinenemia
Ploycythemia
Thrombocytosis
basophilia
FCM studies for mature B neoplasms
Indispensable for mature B neoplasms
Light chain restriction
some lack Ig:mediastinal B, thymic B, PC
Aberrant antigen.
Myeloid Ag ----LPL
CD5: caution non-neoplastic CD5+ B-cells.
FCM studies for mature B neoplasms
False negative
Sample error
Cell lost during processing
Paucity of neoplastic cells
Difficult to identify cell population
CD20 negative after Rituximab.
FCM studies for mature B neoplasms
Identify
target for treatment. (CD20)
Prognostic information(ZAP-70)
MRD