Automated database-guided expert-supervised orientation for immunophenotypic diagnosis and classification of acute leukemia

Autor: Lhermitte, L, Mejstrikova, E, van der Sluijs-Gelling, A J, Grigore, G E, Sedek, L, Bras, A E, Gaipa, G, Sobral da Costa, E, Novakova, M, Sonneveld, E, Buracchi, C, de Sá Bacelar, T, te Marvelde, J G, Trinquand, A, Asnafi, V, Szczepanski, T, Matarraz, S, Lopez, A, Vidriales, B, Bulsa, J, Hrusak, O, Kalina, T, Lecrevisse, Q, Martin Ayuso, M, Brüggemann, M, Verde, J, Fernandez, P, Burgos, L, Paiva, B, Pedreira, C E, van Dongen, J J M, Orfao, A, van der Velden, V H J
Zdroj: Leukemia; April 2018, Vol. 32 Issue: 4 p874-881, 8p
Abstrakt: Precise classification of acute leukemia (AL) is crucial for adequate treatment. EuroFlow has previously designed an AL orientation tube (ALOT) to guide towards the relevant classification panel (T-cell acute lymphoblastic leukemia (T-ALL), B-cell precursor (BCP)-ALL and/or acute myeloid leukemia (AML)) and final diagnosis. Now we built a reference database with 656 typical AL samples (145 T-ALL, 377 BCP-ALL, 134 AML), processed and analyzed via standardized protocols. Using principal component analysis (PCA)-based plots and automated classification algorithms for direct comparison of single-cells from individual patients against the database, another 783 cases were subsequently evaluated. Depending on the database-guided results, patients were categorized as: (i) typical T, B or Myeloid without or; (ii) with a transitional component to another lineage; (iii) atypical; or (iv) mixed-lineage. Using this automated algorithm, in 781/783 cases (99.7%) the right panel was selected, and data comparable to the final WHO-diagnosis was already provided in >93% of cases (85% T-ALL, 97% BCP-ALL, 95% AML and 87% mixed-phenotype AL patients), even without data on the full-characterization panels. Our results show that database-guided analysis facilitates standardized interpretation of ALOT results and allows accurate selection of the relevant classification panels, hence providing a solid basis for designing future WHO AL classifications.
Databáze: Supplemental Index
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