PMID- 37544763 OWN - NLM STAT- MEDLINE DCOM- 20231112 LR - 20231112 IS - 0376-2491 (Print) IS - 0376-2491 (Linking) VI - 103 IP - 29 DP - 2023 Aug 8 TI - [Diagnostic and prognostic values of flow cytometry in diffuse large B-cell lymphoma with bone marrow involvement]. PG - 2258-2265 LID - 10.3760/cma.j.cn112137-20230223-00259 [doi] AB - Objective: To analyze the diagnostic and prognostic values of flow cytometry (FC) in diffuse large B cell lymphoma (DLBCL) with bone marrow involvement (BMI). Methods: The clinical data of 412 patients with newly diagnosed DLBCL, including 243 males and 169 females, aged 64 (28-92) years old, in the Department of Hematology at Peking University Third Hospital from December 2012 to June 2022 were retrospectively analyzed. All patients underwent bone marrow biopsy (BMB) and bone marrow FC. The patients with BMI by FC were further detected by fluorescence in situ hybridization (FISH) for gene analysis. The positive rates and consistency of BMI detected by BMB and FC were evaluated. According to the results of BMB and FC examinations, all patients were divided into four groups: the BMB(+)FC(+)group (115 cases), the BMB(-)FC(+)group (50 cases), the BMB(+)FC(-)group (8 cases, the results did not include in statistical analysis because of small sample size), and the BMB(-)FC(-)group (239 cases). The clinical features, treatment response rates, 5-year survival rates, and immunophenotype characteristics by FC in different groups were analyzed. Results: Among the 412 patients with DLBCL, the positivity rates of BMB and FC for BMI detection were 29.9% (123/412) and 40.0% (165/412), respectively. Good consistency between BMB and FC was found (Kappa=0.841, P=0.001). The numbers of extranodal involvement>/=2, splenomegaly, huge mass, higher Ki-67 score, higher international prognostic index (IPI) score, thrombocytopenia, and elevated lactate dehydrogenase level were more prevalent in the BMB(+)FC(+)group than those in the BMB(-)FC(+)group and the BMB(-)FC(-)group (all P<0.05). The treatment response rate in BMB(+)FC(+)group was 63.5% (73/115), which was lower than those in BMB(-)FC(+)group (88.0%, 44/50, P=0.048) and BMB(-)FC(-)group (90.0%, 215/239, P=0.032), respectively. The 5-year overall survival rates in three groups were (53.6+/-9.7) %, (72.5+/-8.6) %, and (75.2+/-7.6) %, respectively, with a statistically significant difference (P=0.037). According to the FISH results of bone marrow, 102 cases were diagnosed as not otherwise specified (NOS), 48 cases were diagnosed as double hit lymphoma (DHL), and 15 cases were diagnosed as triple hit lymphoma (THL). Compared with NOS subtypes, the tumor cells in DHL or THL subtypes had higher proportion of increased side scatter (SSC), higher positive rates of CD10 expression, CD38 strong expression and CD56 expression, and lower proportion of surface immunoglobulin light chain restriction (all P<0.05). Conclusions: FC is well consistent with BMB in diagnosing DLBCL with BMI. Combined with FISH detection, FC can contribute to the auxiliary diagnosis and risk stratification for DHL and THL, and provide reference for the prognostic evaluation in DLBCL with BMI. FAU - Hong, Y AU - Hong Y AD - Department of Hematology, Peking University Third Hospital, Beijing 100191, China. FAU - Wan, W L AU - Wan WL AD - Department of Hematology, Peking University Third Hospital, Beijing 100191, China. FAU - Li, M AU - Li M AD - Department of Pathology, Peking University Third Hospital, Beijing 100191, China. FAU - Wang, H AU - Wang H AD - Department of Hematology, Peking University Third Hospital, Beijing 100191, China. FAU - Dong, F AU - Dong F AD - Department of Hematology, Peking University Third Hospital, Beijing 100191, China. FAU - Jing, H M AU - Jing HM AD - Department of Hematology, Peking University Third Hospital, Beijing 100191, China. FAU - Ke, X Y AU - Ke XY AD - Department of Hematology, Peking University Third Hospital, Beijing 100191, China. FAU - Zhu, M X AU - Zhu MX AD - Department of Hematology, Peking University Third Hospital, Beijing 100191, China. LA - chi PT - English Abstract PT - Journal Article PL - China TA - Zhonghua Yi Xue Za Zhi JT - Zhonghua yi xue za zhi JID - 7511141 SB - IM MH - Humans MH - *Lymphoma, Large B-Cell, Diffuse/diagnosis MH - *Bone Marrow/pathology MH - Flow Cytometry MH - Male MH - Female MH - Retrospective Studies MH - In Situ Hybridization, Fluorescence EDAT- 2023/08/07 00:42 MHDA- 2023/08/08 06:42 CRDT- 2023/08/06 21:34 PHST- 2023/08/08 06:42 [medline] PHST- 2023/08/07 00:42 [pubmed] PHST- 2023/08/06 21:34 [entrez] AID - 10.3760/cma.j.cn112137-20230223-00259 [doi] PST - ppublish SO - Zhonghua Yi Xue Za Zhi. 2023 Aug 8;103(29):2258-2265. doi: 10.3760/cma.j.cn112137-20230223-00259.