Reporting clinical results

Tony Bakke bakkea at ohsu.edu
Thu Jan 25 13:56:11 EST 2007


There are concensus recommendations on clinical reports published in Cytometry in 1997. 
The second concensus conference last summer only added a couple of newer requirements for
reporting, such as electronic contacts and signatures.

In general the use of percentages is NOT recommended for clinical reports, but rather a
discription of the positive markers on the population of interest, the relative intensity
of staining with the marker (dim, moderate, bright) and the percentage of this population
in the total population (like a differential).	These issues are also covered in
Cytometry, the same issue.

Regards,
Tony

Tony Bakke, PhD, D(ABMLI)
Professor of Pathology
Oregon Health & Science U.
503 494-4687

>>> <Paresh_jain at bd.com> 12/19/2006 10:23:17 PM >>>
Hi Lydene

One  way of reporting results on leukemia flow cytometry is to give 
percentage positivity of individual markers and then add a line in the 
report that states "Above percentages are on a blast gate defined on a 
FSC/SSC plot OR SSC/CD45 plot (whichever was used) that comprises 
.....% of all events.

A good leukemia flow report - in my opinion - should include the 
following:

Patient details: Name, Age, Sex, Referring doctor etc.
Sample details: Sample Id, Sample type, date/time of collection etc.

Markers used
	(here one gives the percentage positivity and the details of 
gating strategy used)
Markers summary
	Positive:
	Dim:
	Negative:
Final Impression: eg Precursor B-lineage ALL (Type 1) etc.

Some labs choose not to give details of percentage positivity and give 
only marker summary in the reports. This is more of a lab policy issue. 
However if one does decide to give percentages, it is better to include 
the details of gating strategy as well.

Flow BM samples can sometimes get diluted with peripheral blood and thus 
result in discrepant blast percentage than what is observed on BM touch 
smears. So, I recommend to restrict the of use flow for characterising the 
blast phenotype and rely on bone marrow touch smear for evaluating the 
exact percentage of blasts.

I hope this is helpful.

regards
Paresh



Dr. Paresh Jain
Scientific Advisor / Technical Services

BD Biosciences
Signature Tower-B, South City 1, Gurgaon, Haryana 122001 India 
tel: +91 124 2383566  cell: +91 9811275447  fax: +91 124 2383224/5/6
E-mail: paresh_jain at bd.com   Website: www.bd.com 




"Lydene McArthur" <Lydene.McArthur at cdhb.govt.nz> 
12/15/2006 07:59 AM

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Subject
Reporting clinical results






Hi everyone
I would like to get some feedback about reporting clinical flow cytometry 
results for bone marrow samples.  Does everyone report the percentage of 
abnormal and normal cell populations present.  If so, what value do you 
use to express the result - do you report each population as a percentage 
of CD45 positive cells, or as a percentage of total nucleated cells in the 
sample.
My reason for asking - we have a bone marrow sample from a patient with 
erythroleukaemia.  The morphology differential shows 89% erythroid 
precursors and 4% blasts.  The flow cytometry results show 20% 
erythroblasts (bright CD71/glycophorin A) and a smaller number of 
myeloblasts.  The percentage of erythroblasts between the two techniques 
is markedly different.	I have tried to explain to our Haematologist this 
is most likely due to the red cell lysing technique used to prepare the 
sample which can result in selective loss of red cell precursors (we are 
using ammonium chloride).  But I don't know whether he believes me!! 
Does anyone else have experience with flow cytometry analysis of 
erythroleukaemia?.  How do you report the results when the erythroid cell 
percentages are so different between the two techniques. 
Many thanks and christmas cheers (hic!)
Lydene McArthur
Haematology Surface Markers
Canterbury Health Laboratories
Christchurch
New Zealand
Phone +64 3 3640 917
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