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The utility of flow cytometry as a useful diagnostic modality for the assessment of hematopoietic neoplasms has been established beyonddoubt. In fact, it is now an integral part of the diagnosis and classification of various diseases like leukemias and lymphomas along withmolecular studies and cytogenetics. Prognostication and disease monitoring by flow cytometry is also being recognized increasingly asone of the important fortes. This is evident by the number of articles in the published in literature on the minimal residual disease detectionby flow cytometry especially in the last decade or so. To add to this, ever growing list of utilities in hematopoietic malignancies, many non-hematopoietic neoplasms can also be analyzed by flow cytometry. The examples include fluid specimens from serous cavity effusionsand samples from solid tissues like lymph nodes, reticulo-endothelial tissue, central nervous system tissue, etc. Flow cytometry techniqueprovides a unique blend of rapidity, high sensitivity and specificity compared to cyto-morphology and conventional immunohistochemicalstaining. It is also remarkable for simultaneous analysis of more than one marker on the cells. Evaluation of limited samples such ascerebrospinal fluid or fine needle aspiration samples makes Flow cytometry a valuable tool. DNA ploidy analysis and assessment ofpediatric non-hematopoietic neoplasms by Flow cytometry has envisaged the utility vista of this technique. This review is aimed atproviding an insight into the applications of flow cytometry in pediatric malignancies.
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Introduction: Beta thalassemia trait (BTT) must be differentiated from iron defi ciency anemia to avoid unnecessary iron therapy and for the prevention of thalassemia major by genetic counseling. In a tertiary care hospital, it is vital that the screening tool is not only sensitive but also specifi c so as to be cost effective and save time. Aim: The aim of this study was to evaluate the new Sehgal index and compare it to existing complete blood count-based indices for the best combination of sensitivity and specifi city to predict BTT. Materials and Methods: Study was done in 2 phases - Phase 1: A retrospective analysis of 1022 consecutive high-performance liquid chromatography (HPLC) cases from July 2008 to June 2011. Phase 2: A prospective analysis of 973 consecutive HPLC cases from July 1, 2011 to June 10, 2013 was done to confi rm the results of Phase 1 and the applicability of the new Sehgal index. Results: Prevalence of BTT was 28.8% (294/1022) and 25.39% (247/973) in Phase 1 and Phase 2, respectively. Receiver operating characteristic-area under the curve and Youden index was highest for new Sehgal index, followed by Mentzers index <14. The prospective study shows results similar to those in Phase 1 confi rming the superiority of the above two indices. Conclusion: Sehgal index and Mentzers index <14 showed the best combination of sensitivity and specifi city in predicting BTT. The best indices or combination can be used as a “validated fl ag rule” in the analyzer middleware program in a hospital for identifying suspected cases of BTT.
RESUMEN
Background: There are several methods for counting platelets, of which the international fl ow reference method (IRM) is considered to be the gold standard. We compared the platelet count given by this method to the count given by automated analyzers using other methods, such as optical fl uorescence and impedance. Aims: The aim of this study is to compare the platelet counts obtained by Sysmex XE 2100 by Impedance (Sysmex-I), optical fl orescence (Sysmex-O) and reported (Sysmex-R) based on the switching algorithm and LH-750 by Impedance (LH-750) with the IRM in thrombocytopenic blood samples. To calculate the sensitivity, specifi city, positive predictive value (PPV) and negative predictive value (NPV) of various technologies at the clinically relevant transfusion thresholds of 10 × 109/l and 20 × 109/l. Materials and Methods: A total of 118 blood samples with platelet count of <50 × 109/l were selected for the study. Platelet counts of all samples were analyzed by all methods using the Sysmex analyzer, LH-750 and IRM in parallel within 6 h of collection. Statistical Analysis Used: Pearson correlation, bland Altman analysis, sensitivity and specifi city, PPV and NPV. Results and Conclusions: Sysmex-R had the least Bias and 95% limits of agreement (95%LA) range and thus correlated best with IRM values. LH-750 had a higher Bias compared to Sysmex-O and Sysmex-R, but a strikingly similar 95% LA ensures similar results in all three methods. In fact, in the oncology subset, it had the narrowest 95% LA, which made it the best performer in this subgroup. Of the three Sysmex results, Sysmex-I had the highest bias, widest 95% LA and highest potential risk of over transfusion. Hence, Sysmex-R and LH-750 were found to be reliable tools for estimation of platelet count in thrombocytopenic patients.