Emina Emilia Torlakovic, Katherine R Calvo, Tracy George, Elizabeth Hyjek, Szu-Hee Lee, Anna Porwit, Elena Sabattini, Leonie Saft, Xiaoge Zhou, Alexandar Tzankov
Introduction: Investigation of bone marrow (BM) trephine biopsies and/or clot sections by CD34 immunohistochemistry (IHC) testing has been used by pathologists for several decades, and its clinical value has been well established with QBEND10 being the most frequently used primary antibody (Ab) clone. However, most other parameters related to the IHC protocol as well as the readout vary widely between clinical laboratories and in the published literature. The ICSH Working Group having reviewed the published evidence has established guidelines that will help to harmonize performance and reporting of CD34 IHC on BM biopsies.
Methods: The methodology is based on the published "guidelines for guidelines" (GRADE, AGREE) with modifications to the specific laboratory medicine environment and to specific key questions. Review of the published literature resulted in 49 articles relevant to clinical applications of the BM CD34 IHC. Five key questions were addressed including testing indications, technical performance, readout methodology, terminology, and reporting.
Results: A total of 23 guidelines were grouped according to the key questions.
Conclusion: BM CD34 IHC testing is complex with both the protocol and the pathologist's readout requiring validation to ensure reported results are reproducible and accurate. The readout/interpretation must be adapted to a specific purpose of the assay (clinicopathological question) and the type and overall sample quality. Standardized terminology and reporting are essential if CD34 IHC assay is being used for clinical diagnostics.
{"title":"Clinical Applications of Bone Marrow CD34 Immunohistochemistry (BM CD34 IHC) Assay: International Council for Standardization in Hematology (ICSH) Guidelines.","authors":"Emina Emilia Torlakovic, Katherine R Calvo, Tracy George, Elizabeth Hyjek, Szu-Hee Lee, Anna Porwit, Elena Sabattini, Leonie Saft, Xiaoge Zhou, Alexandar Tzankov","doi":"10.1111/ijlh.14411","DOIUrl":"https://doi.org/10.1111/ijlh.14411","url":null,"abstract":"<p><strong>Introduction: </strong>Investigation of bone marrow (BM) trephine biopsies and/or clot sections by CD34 immunohistochemistry (IHC) testing has been used by pathologists for several decades, and its clinical value has been well established with QBEND10 being the most frequently used primary antibody (Ab) clone. However, most other parameters related to the IHC protocol as well as the readout vary widely between clinical laboratories and in the published literature. The ICSH Working Group having reviewed the published evidence has established guidelines that will help to harmonize performance and reporting of CD34 IHC on BM biopsies.</p><p><strong>Methods: </strong>The methodology is based on the published \"guidelines for guidelines\" (GRADE, AGREE) with modifications to the specific laboratory medicine environment and to specific key questions. Review of the published literature resulted in 49 articles relevant to clinical applications of the BM CD34 IHC. Five key questions were addressed including testing indications, technical performance, readout methodology, terminology, and reporting.</p><p><strong>Results: </strong>A total of 23 guidelines were grouped according to the key questions.</p><p><strong>Conclusion: </strong>BM CD34 IHC testing is complex with both the protocol and the pathologist's readout requiring validation to ensure reported results are reproducible and accurate. The readout/interpretation must be adapted to a specific purpose of the assay (clinicopathological question) and the type and overall sample quality. Standardized terminology and reporting are essential if CD34 IHC assay is being used for clinical diagnostics.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abhishek Prasad, Eric D Carlsen, Sergio Pina-Oviedo, Luis F Carrillo
{"title":"Concurrent Loss of CD16 in Granulocytes and CD14 in Mature Monocytes in a Patient With Pancytopenia: A Diagnostic Clue for Paroxysmal Nocturnal Hemoglobinuria.","authors":"Abhishek Prasad, Eric D Carlsen, Sergio Pina-Oviedo, Luis F Carrillo","doi":"10.1111/ijlh.14417","DOIUrl":"https://doi.org/10.1111/ijlh.14417","url":null,"abstract":"","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Post-Induction Bone Marrow Necrosis With Carbapenem-Resistant Enterobacteriaceae in a Case of B-Acute Lymphoblastic Leukemia.","authors":"Prerna Arora, Deepika Yadav, Jasmita Dass, Mukul Aggarwal, Vishwanath Singh Yadav, Arti Kapil","doi":"10.1111/ijlh.14407","DOIUrl":"https://doi.org/10.1111/ijlh.14407","url":null,"abstract":"","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elsa Bera, Liana Veresezan, Maïssa Souissi, Fanny Drieux, Pierre Lebreton, Victor Bobée
{"title":"Relapse of Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma (MEITL) in a Pericardial Fluid.","authors":"Elsa Bera, Liana Veresezan, Maïssa Souissi, Fanny Drieux, Pierre Lebreton, Victor Bobée","doi":"10.1111/ijlh.14398","DOIUrl":"https://doi.org/10.1111/ijlh.14398","url":null,"abstract":"","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Atypical Melanocytic Cells in the Cerebrospinal Fluid of a 7-Year-Old Child With Headaches.","authors":"Weijie Li, Suzanne Schauwecker, Trevor Gerson","doi":"10.1111/ijlh.14399","DOIUrl":"https://doi.org/10.1111/ijlh.14399","url":null,"abstract":"","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cytomorphological Evaluation in a Pediatric Case of Metastatic Neuroblastoma: A Challenging Diagnosis due to Unusual Differentiation.","authors":"K Truijens, C Van Aerde, T Tousseyn, M Tajdar","doi":"10.1111/ijlh.14388","DOIUrl":"https://doi.org/10.1111/ijlh.14388","url":null,"abstract":"","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 51-year-old woman visited the emergency department because of intermittent fever for more than 2 weeks. Physical examination found symmetrical pitting edema of the extremities. Computed tomography and ultrasound showed multiple serous effusions and splenomegaly. A complete blood cell analysis showed moderate anemia and severe thrombocytopenia. Abnormal cells in a subsequent peripheral blood smear accounted for 5%. The bone marrow smear showed a large number of abnormal cells (69.5%), with large cell bodies and pseudopod protrusions. Huge multinucleated cells were visible. Nucleoli were visible in some nuclei, and mitotic figures were evident. The abnormal cells by peroxidase staining were negative, and the positive rate by periodic acid-Schiff staining was 62%. Bone marrow biopsy revealed diffuse infiltration of heterotypic cells (approximately 80%). Later, she was transferred to the hematology department. The phenotypes by flow cytometry were CD117bri+, CD30+, MPO-, CD2-, and CD25-. The molecular test for KIT gene mutation was negative, and multiple karyotypes were abnormal and complex. The final diagnosis was mast cell leukemia. The patient eventually died approximately 1 month after the diagnosis.
{"title":"Acute Mast Cell Leukemia With Complex Karyomorphism and Karyotypes.","authors":"Sha Li, Yantian Zhao","doi":"10.1111/ijlh.14384","DOIUrl":"https://doi.org/10.1111/ijlh.14384","url":null,"abstract":"<p><p>A 51-year-old woman visited the emergency department because of intermittent fever for more than 2 weeks. Physical examination found symmetrical pitting edema of the extremities. Computed tomography and ultrasound showed multiple serous effusions and splenomegaly. A complete blood cell analysis showed moderate anemia and severe thrombocytopenia. Abnormal cells in a subsequent peripheral blood smear accounted for 5%. The bone marrow smear showed a large number of abnormal cells (69.5%), with large cell bodies and pseudopod protrusions. Huge multinucleated cells were visible. Nucleoli were visible in some nuclei, and mitotic figures were evident. The abnormal cells by peroxidase staining were negative, and the positive rate by periodic acid-Schiff staining was 62%. Bone marrow biopsy revealed diffuse infiltration of heterotypic cells (approximately 80%). Later, she was transferred to the hematology department. The phenotypes by flow cytometry were CD117bri+, CD30+, MPO-, CD2-, and CD25-. The molecular test for KIT gene mutation was negative, and multiple karyotypes were abnormal and complex. The final diagnosis was mast cell leukemia. The patient eventually died approximately 1 month after the diagnosis.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acute Myeloid Leukaemia With Morphologic and Immunophenotypic Differentiation to Acute Erythroid Leukaemia at the Time of Relapse.","authors":"Katie Liston, Vitaliy Mykytiv","doi":"10.1111/ijlh.14386","DOIUrl":"https://doi.org/10.1111/ijlh.14386","url":null,"abstract":"","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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