title: Sensitivity and specificity of cerebrospinal fluid flow cytometry for the diagnosis of leukemic meningitis in acute lymphoblastic leukemia/lymphoma.
abstract: The presence of leukemic blasts detected by light microscopy in cerebrospinal fluid (CSF) establishes the diagnosis of leukemic meningitis in acute lymphoblastic leukemia/lymphoma (ALL). Flow cytometry immunophenotyping (FCI) is a very sensitive method that detects a minute number of aberrant cells, and is increasingly performed on CSF samples. We sought to determine the sensitivity and specificity of CSF FCI for the diagnosis of leukemic meningitis in ALL. Between November 2007 and August 2011, 800 CSF samples from 80 patients with ALL were available from diagnostic lumbar punctures (LPs; n = 80), follow-up LPs (n = 687) and at the time of relapse (n = 33). FCI was performed on 267 samples, and only identified aberrant cells in cytologically confirmed cases of leukemic meningitis. A blinded review of all cases with detectable CSF nucleated cells confirmed these findings. We conclude that CSF FCI has a 100% sensitivity and specificity for the detection of lymphoblasts. However, additional studies are needed to define the role this procedure plays in the diagnosis of leukemic meningitis.
authors.affiliation: Department of Medicine.
authors.forename: Zahi
authors.initials: Z
authors.lastname: Mitri
authors.forename: Momin T
authors.initials: MT
authors.lastname: Siddiqui
authors.forename: Fuad
authors.initials: F
authors.lastname: El Rassi
authors.forename: Jeannine T
authors.initials: JT
authors.lastname: Holden
authors.forename: Leonard T
authors.initials: LT
authors.lastname: Heffner
authors.forename: Amelia
authors.initials: A
authors.lastname: Langston
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Waller
authors.forename: Elliott
authors.initials: E
authors.lastname: Winton
authors.forename: Morgan
authors.initials: M
authors.lastname: McLemore
authors.forename: Leon
authors.initials: L
authors.lastname: Bernal-Mizrachi
authors.forename: David
authors.initials: D
authors.lastname: Jaye
authors.forename: Martha
authors.initials: M
authors.lastname: Arellano
authors.forename: Hanna Jean
authors.initials: HJ
authors.lastname: Khoury
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000556:secondary*; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000473:pathology*; D012008:Recurrence; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Lymphoblastic lymphoma; cerebrospinal fluid; flow cytometry; sensitivity; specificity