Abstract
ContextThe detection of low‐level persistent or relapsed B‐cell neoplasms, particularly post‐therapy, can be challenging, often requiring multiple testing modalities.ObjectiveHere we investigate the utility of CD19‐based selection of neoplastic B‐cells (CD19S) as an enrichment strategy to improve the detection rate of cytogenetic abnormalities in post‐therapy samples of B‐cell neoplasms, especially those with low‐level disease.DesignIn a cohort largely comprised of post‐therapy B‐ALL and CLL samples, we performed fluorescence in situ hybridization (FISH) analysis on CD19‐selected cells (CD19S FISH) in 128 specimens from 88 patients, and on non‐selected cells (NS FISH) in a subset of cases. The FISH findings were compared with the concurrent flow cytometry (FC) results in all samples and molecular analysis in a subset.ResultsCD19S FISH was able to detect cytogenetic aberrations in 86.0% of post‐therapy samples with evidence of disease as determined by routine or MRD FC, compared to 59.1% of samples by NS FISH. CD19S FISH detected significantly higher percentages of positive cells compared to NS FISH (p < 0.001). Importantly, CD19S FISH enabled the detection of emergent subclones (clonal evolution) associated with poor prognosis.ConclusionsCD19S FISH can be useful in daily diagnostic practice. Compared to NS FISH, CD19S FISH is quantitatively and qualitatively superior for the detection of cytogenetic aberrations in B‐cell neoplasms, which are important for risk stratification and optimal management of patients with B‐cell neoplasms, especially in the relapsed setting. Although CD19S FISH has a diagnostic sensitivity inferior to that of MRD FC, the sensitivity of this modality is comparable to routine FC for the evaluation of low‐level disease in the post‐therapy setting. Moreover, CD19S samples are invaluable for additional molecular and genetic analyses.
Highlights
Detection of cytogenetic or molecular aberrations plays an integral role in the diagnosis, classification, and management of B-c ell neoplasms.[1]
The aim of the present study was to compare the findings of interphase fluorescence in situ hybridization (FISH) analysis performed on CD19-selected cells (CD19S FISH) with those of FISH performed on non-selected cells (NS FISH), and compare the results with concurrent flow cytometry (FC) analysis and molecular polymerase chain reaction (PCR) analysis in various types of mature and immature CD19-p ositive B-c ell neoplasms
We demonstrate the advantages of CD19-selection in detecting cytogenetic aberrations in post-therapy samples of immature and mature B-c ell neoplasms
Summary
1. A systematic comparison of CD19S FISH versus NS FISH analysis establishes superiority (qualitative and quantitative) of the former modality in detecting post- therapy persistence or relapse of B-cell neoplasms. 2. CD19S FISH can complement flow cytometric evaluation for the detection of low- level involvement in B-cell neoplasms and in the detection of post- therapy recurrent/emerging small subclones. 3. Flow cytometry detection of
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
