title: Automated quantification of apoptosis in B-cell chronic lymphoproliferative disorders: a prognostic variable obtained with the Cell-Dyn Sapphire (Abbott) automated hematology analyzer.
abstract: BACKGROUND
  B-chronic lymphocytic leukemia CLL, a neoplastic clonal disorder with monomorphous small B lymphocytes with scanty cytoplasm and clumped chromatin, can be morphologically differentiated in typical and atypical forms with different prognosis: Smudge cells (Gumprecht's shadows) are one of the well-known features of the typical CLL and are much less inconsistent in other different types CLPD. Abbott Cell-Dyn Sapphire uses the fluorescence after staining with the DNA fluorochrome propidium iodide for the measurement of nucleated red blood cells (NRBCs) and nonviable cells (FL3+ cell fraction): We have studied the possible correlation between presence and number of morphologically identifiable smudge cells on smears and the percentage of nonviable cells produced by Cell-Dyn Sapphire.
  
  
  METHODS
  305 blood samples from 224 patients with B-cell lymphoproliferative disorders and 40 healthy blood donors were analyzed by CBC performed by Cell-Dyn Sapphire, peripheral blood smear, and immunophenotype characterization.
  
  
  RESULTS
  FL3+ fraction in CLPD directly correlated with the percentage of smudge cells and is significantly increased in patients with typical B-CLL. This phenomenon is much less evident in patients with atypical/mixed B-CLL and B-NHL.
  
  
  CONCLUSIONS
  In small laboratories without FCM and cytogenetic, smudge cells%, can be utilized as a preliminary diagnostic and prognostic tool in differential diagnosis of CLPD.
authors.affiliation: Clinical Pathology Laboratory, A.O.R.N 'G. Rummo' di Benevento, Benevento, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Fumi
authors.forename: D
authors.initials: D
authors.lastname: Martins
authors.forename: Y
authors.initials: Y
authors.lastname: Pancione
authors.forename: S
authors.initials: S
authors.lastname: Sale
authors.forename: V
authors.initials: V
authors.lastname: Rocco
mesh_terms: D017209:Apoptosis; D057205:Automation, Laboratory; D001402:B-Lymphocytes / Q000145:classification / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007943:Leukemia, Hairy Cell / Q000175:diagnosis* / Q000473:pathology; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000473:pathology; D018655:Lymphocyte Count / Q000295:instrumentation*; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013154:Spleen / Q000473:pathology
keywords: Gumprecht; Iodide; Lymphoproliferative; Sapphire; propidium; smudge cells