Análise da presença de células neoplásicas no sangue periférico por citometria de fluxo em pacientes com linfoma não-Hodgkin

Abstract

Non-Hodgkin lymphoma (NHL) is the most common hematological neoplasm in the world, and bone marrow biopsy is routinely performed for proper tumor staging. New techniques have been studied to allow faster identification of the disease, such as flow cytometry immunophenotyping (FCI). In relation to peripheral blood, to date there is no consensus on the performance of FCI. The real value of the FCI in peripheral blood for the diagnosis and staging of NHL is not known. Therefore, we analyzed whether it is possible to identify the presence of circulating neoplastic cells in peripheral blood of patients with NHL through the ICF, as well as we compared the findings with the initial staging by bone marrow biopsy. Nine samples were analyzed using a panel of monoclonal antibodies aimed at the study of chronic b-cell lymphoproliferative diseases. Sequential gates were analyzed and the results compared with the histological evaluation of the bone marrow. Of the nine cases analyzed, three were in disagreement with the pathological bone marrow result on the staging examination, and the biopsy was negative for infiltration into NHL while the ICF was positive. These cases presented low tumor load, which may justify disagreement. Flow cytometry immunophenotyping has been studied for the diagnosis, staging and follow-up of patients with NHL. The use of peripheral blood as a material for staging in NHL is feasible, presents a good sensitivity, especially for the analysis of small neoplastic populations, besides being an easy sample to obtain.