Flow cytometry with or without cytochemistry for the diagnosis of XXXX ?

@entity2799 @entity981 @entity706 @entity3052 @entity1778
Ninety-three (93) cases of acute @entity1778 were assessed using flow cytometry and cytochemistry and assigned to one of four categories: myeloid, lymphoid, biphenotypic, and non-diagnostic. In @entity1778 designated as @entity981 or @entity3052 by both methodologies, there was lineage agreement in all but 3 of 71 cases (95.8%). However, when nondiagnostic or biphenotypic diagnoses made by either methodology were included, complete agreement occurred in only 77.4% of cases. Of 37 cases designated myeloid origin by flow cytometry, 33 (89.2%) were read as myeloid by cytochemistry. The four discordant diagnosis were read as lymphoid (2) or as non-diagnostic (2). Eighty percent of @entity706 were diagnosed as such by both flow cytometry and cytochemistry; one early B cell @entity981 was diagnosed as myeloid and 8 as non-diagnostic. Fifty percent (50%) of flow cytometry defined T-cell @entity981 were considered non-diagnostic by cytochemistry as compared to 17% of the total @entity981 group. Of the remaining four designated non-T cell @entity981 by flow cytometry and non-diagnostic by cytochemistry, three were read by flow cytometry to be standard pre-B @entity981 and one an early B-cell @entity981 . Only 2/9 @entity1778 considered biphenotypic by flow were identified as such by cytochemistry. Given (1) the potential importance of non-lineage expression in the prognosis of myeloid and @entity706 , (2) cytochemistry's impaired ability to diagnose biphenotypic, T-cell, and @entity2799 , and (3) the increased costs incurred in diagnosis when both modalities are used, perhaps it is time to re-examine the utility of performing both flow cytometry and cytochemistry as initial testing for @entity1778 categorization.
