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Wood B.L.,University of Washington | Wood B.L.,Hematopathology Laboratory
Journal of Hematopathology | Year: 2015

Acute leukemia is the most common group of neoplasms diagnosed in the pediatric population, the most frequent being acute lymphoblastic leukemia of B cell lineage. Immunophenotyping has come to play an integral role in the enumeration of leukemic populations, assignment of lineage, identification of prognostic subgroups, and subsequent post-therapeutic monitoring. This review will describe the current status of flow cytometric immunophenotyping as applied to the diagnosis and monitoring of pediatric patients with acute leukemia and suggest areas for future investigation. © 2014, Springer-Verlag Berlin Heidelberg. Source

Dawson A.J.,Cytogenetics Laboratory | Dawson A.J.,University of Manitoba | Yanofsky R.,University of Manitoba | Vallente R.,Genomic Center for Cancer Research and Diagnostics | And 5 more authors.
Current Oncology | Year: 2011

Most patients with acute lymphocytic leukemia (ALL) are reported to have acquired chromosomal abnormalities in their leukemic bone marrow cells. Many established chromosome rearrangements have been described, and their associations with specific clinical, biologic, and prognostic features are well defined. However, approximately 30% of pediatric and 50% of adult patients with ALL do not have cytogenetic abnormalities of clinical significance. Despite significant improvements in outcome for pediatric ALL, therapy fails in approximately 25% of patients, and these failures often occur unpredictably in patients with a favorable prognosis and "good" cytogenetics at diagnosis. It is well known that karyotype analysis in hematologic malignancies, although genome-wide, is limited because of altered cell kinetics (mitotic rate), a propensity of leukemic blasts to undergo apoptosis in culture, overgrowth by normal cells, and chromosomes of poor quality in the abnormal clone. Array comparative genomic hybridization (aCGH- "microarray") has a greatly increased genomic resolution over classical cytogenetics. Cytogenetic microarray, which uses genomic dna, is a powerful tool in the analysis of unbalanced chromosome rearrangements, such as copy number gains and losses, and it is the method of choice when the mitotic index is low and the quality of metaphases is suboptimal. The copy number profile obtained by microarray is often called a "molecular karyotype." In the present study, microarray was applied to 9 retrospective cases of pediatric ALL either with initial high-risk features or with at least 1 relapse. The conventional karyotype was compared to the "molecular karyotype" to assess abnormalities as interpreted by classical cytogenetics. Not only were previously undetected chromosome losses and gains identified by microarray, but several karyotypes interpreted by classical cytogenetics were shown to be discordant with the microarray results. The complementary use of microarray and conventional cytogenetics would allow for more sensitive, comprehensive, and accurate analysis of the underlying genetic profile, with concomitant improvement in prognosis and treatment, not only for pediatric ALL, but for neoplastic disorders in general. © 2011 Multimed Inc. Source

Agarwal M.B.,Bombay Hospital Institute of Medical science | Malhotra H.,Birla Cancer Center | Chakrabarti P.,Nrs Medical College | Varma N.,Jawaharlal Institute of Postgraduate Medical Education & Research | And 17 more authors.
Indian Journal of Medical and Paediatric Oncology | Year: 2015

According to the 2008 revision of the World Health Organization (WHO) classification of myeloid malignancies, philadelphia chromosome (Ph)-negative myeloproliferative neoplasms (MPNs) include clonal, hematologic disorders such as polycythemia vera, primary myelofibrosis, and essential thrombocythemia. Recent years have witnessed major advances in the understanding of the molecular pathophysiology of these rare subgroups of chronic, myeloproliferative disorders. Identification of somatic mutations in genes associated with pathogenesis and evolution of these myeloproliferative conditions (Janus Kinase 2; myeloproliferative leukemia virus gene; calreticulin) led to substantial changes in the international guidelines for diagnosis and treatment of Ph-negative MPN during the last few years. The MPN-Working Group (MPN-WG), a panel of hematologists with expertise in MPN diagnosis and treatment from various parts of India, examined applicability of this latest clinical and scientific evidence in the context of hematology practice in India.This manuscript summarizes the consensus recommendations formulated by the MPN-WG that can be followed as a guideline for management of patients with Ph-negative MPN in the context of clinical practice in India. Source

Gujral S.,Hematopathology Laboratory | Dongre K.,Tata Memorial Hospital TMH | Bhindare S.,Administrative Office | Subramanian P.G.,Hematopathology Laboratory | And 6 more authors.
Indian Journal of Pathology and Microbiology | Year: 2010

Background: Cost analysis in laboratories represents a necessary phase in their scientific progression. Aim: To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL) Settings and Design: Activity-based costing (ABC) method is used to calculate per cost test of the hematopathology laboratory. Material and Methods: Information is collected from registers, purchase orders, annual maintenance contracts (AMCs), payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Results: Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Conclusions: Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC), bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management. Source

Gadage V.S.,Hematopathology Laboratory | Kadam Amare P.S.,Cancer Cytogenetic Laboratory | Galani K.S.,Hematopathology Laboratory | Mittal N.,Hematopathology Laboratory
Indian Journal of Pathology and Microbiology | Year: 2012

Systemic mastocytosis with associated clonal hematological nonmast cell lineage disease (SM-AHNMD) is a subtype of mastocytosis associated commonly with myeloid neoplasms, Non-Hodgkin' lymphoma, or other hematological neoplasms. In these conditions, mastocytosis needs to be differentiated from mast cell hyperplasia or mast cell activation states. Neoplastic nature of mastocytosis is proved either by morphology, aberrant immunophenotype, or detection of point mutation at codon-816 of c-kit gene. This is a rare entity, even more so in pediatric population. Herein, we report a case of 14-year-old girl with SM associated with acute myeloid leukemia with maturation with t(8;21). Multifocal dense infiltrate of spindle-shaped mast cells on bone marrow aspirate and biopsy with coexpression of CD2 and CD25 by flow cytometric analysis proved the SM component at the time of diagnosis and persistence at post induction status also. Source

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