title: Identification of leptomeningeal disease in aggressive B-cell non-Hodgkin's lymphoma: improved sensitivity of flow cytometry.
abstract: OBJECTIVE
  Here, we evaluate the sensitivity and specificity of a new 11-parameter flow cytometry (FCM) approach versus conventional cytology (CC) for detecting neoplastic cells in stabilized CSF samples from newly diagnosed aggressive B-cell non-Hodgkin's lymphoma (B-NHL) at high risk of CNS relapse, using a prospective, multicentric study design.
  
  
  METHODS
  Moreover, we compared the distribution of different subpopulations of CSF leukocytes and the clinico-biologic characteristics of CSF+ versus CSF-, patients, in an attempt to define new algorithms useful for predicting CNS disease.
  
  
  RESULTS
  Overall, 27 (22%) of 123 patients showed infiltration by FCM, while CC was positive in only seven patients (6%), with three other cases being suspicious (2%). CC+/FCM+ samples typically had more than 20% neoplastic B cells and/or >or= one neoplastic B cell/microL, while FCM+/CC- samples showed lower levels (P < .0001) of infiltration. Interestingly, in Burkitt lymphoma, presence of CNS disease by FCM could be predicted with a high specificity when increased serum beta2-microglobulin and neurological symptoms coexisted, while peripheral blood involvement was the only independent parameter associated with CNS disease in diffuse large B-cell lymphoma, with low predictive value.
  
  
  CONCLUSIONS
  FCM significantly improves the sensitivity of CC for the identification of leptomeningeal disease in aggressive B-NHL at higher risk of CNS disease, particularly in paucicellular samples.
authors.affiliation: Servicio General de Citometría, Department of Medicine and Centro de Investigación del Cáncer (CIC; USAL/CSIC), Universidad de Salamanca, Salamanca, Spain.
authors.forename: Sandra
authors.initials: S
authors.lastname: Quijano
authors.forename: Antonio
authors.initials: A
authors.lastname: López
authors.forename: Juan
authors.initials: J
authors.lastname: Manuel Sancho
authors.forename: Carlos
authors.initials: C
authors.lastname: Panizo
authors.forename: Guillermo
authors.initials: G
authors.lastname: Debén
authors.forename: Cristina
authors.initials: C
authors.lastname: Castilla
authors.forename: José
authors.initials: J
authors.lastname: Antonio García-Vela
authors.forename: Antonio
authors.initials: A
authors.lastname: Salar
authors.forename: Natalia
authors.initials: N
authors.lastname: Alonso-Vence
authors.forename: Eva
authors.initials: E
authors.lastname: González-Barca
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Peñalver
authors.forename: Josefa
authors.initials: J
authors.lastname: Plaza-Villa
authors.forename: Marta
authors.initials: M
authors.lastname: Morado
authors.forename: José
authors.initials: J
authors.lastname: García-Marco
authors.forename: Jesús
authors.initials: J
authors.lastname: Arias
authors.forename: Javier
authors.initials: J
authors.lastname: Briones
authors.forename: Secundino
authors.initials: S
authors.lastname: Ferrer
authors.forename: Javier
authors.initials: J
authors.lastname: Capote
authors.forename: Concepción
authors.initials: C
authors.lastname: Nicolás
authors.forename: Alberto
authors.initials: A
authors.lastname: Orfao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001402:B-Lymphocytes / Q000473:pathology; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006801:Humans; D007962:Leukocytes / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000134:cerebrospinal fluid* / Q000473:pathology; D008297:Male; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid* / Q000473:pathology; D008875:Middle Aged; D012680:Sensitivity and Specificity; D055815:Young Adult