FLOW CYTOMETRY

FLOW CYTOMETRYGold Standard....................

Leading National Laboratory inCancer Diagnostics

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Dr. Ravi Gaur, MD (Pathology)

Chief Operating Officer (COO)

Oncquest Laboratories Ltd.

● Molecular Biology s Oncology s Infection

● FISH

● Cytogenetic

● Surgical Pathology

● IHC

● Flowcytometry

● Haematology

● Biochemistry

● Immunoassays

● Clinical Pathology

● Microbiology

● Clinical Trial

● Expert in Hospital Lab Management

“World class facilities available under one roof”


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TABLE OF CONTENTS

S.No Contents Page No.

1. FLOWCYTOMETRY .................................................. 5

2. IMPORTANT PANELS

Acute Leukemia Panels ....................................... 13

Chronic lymphoproliferative Disorder ...................... 17

Multiple myeloma ............................................. 19

Leukemia Lymphoma Comprehensive Diagnosis Panel ...19

PNH .............................................................. 20

CD 34 Quest .................................................... 22

CD4/CD8 Enumeration ........................................ 22

T-B-NK Cell ..................................................... 23

HLA B -27 ....................................................... 23

3. FLOWCYTOMETRY IN SOLID TUMORS

DNA Ploidy & Cell Cycle .................................... 24

4. DUMMY REPORTS .............................................. 25-31

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FLOWCYTOMETRY

Flowcytometry is a technology that simultaneously measures and analyzes multiple physical characteristics of single cells, as they flow in a fluid stream through a beam.

The properties measured include a particle`s relative size, relative granularity or internal complexity and relative fluorescence intensity.

It works on the principle of optical-to-electronic coupling systems that records how the cell or particle scatters incident laser light & emit fluorescence.

Flowcytometer has three main systems-

Fluidics system - Transports particle in a stream to the point of interrogation

Optics system - laser & optical filters

Electronic system – to convert light signals to electronic data

Hydrodynamics focusing produces a single stream of particles.

Laser light source is used to excite fluorochromes at a particular wavelength & re-emit leading to fluorescence emission.

Common fluorescent dyes used are FITC, APC, PE & Per CP.

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More than one fluorochrome can be used to analyze several parameters of sample at one time (MULTIPARAMETRIC ANALYSIS).

Optical to electrical data coupling is done by the instrument using photomultiplier tubes (PMTs).

Analysis of flowcytometric data is done using suitable gating strategy to visualize the cells of interest while eliminating unwanted particles i.e. dead cells or debris.

Various combinations of fluorochrome labeled antibodies are used to make dot plots for analysis.

For analysis, blood, bone marrow aspirate body fluids & tissue sample can be used.

Sodium heparin is the preferred anticoagulant for longer stability (upto 72 hrs).

The applications of Flowcytometry in diagnosis include the analysis of leukemia & lymphomas, detection of Minimal Residual Disease (MRD), stem cell enumeration, immunologic monitoring of HIV infected individuals, detection of autoantibodies, DNA content analysis, Immunodeficiency disease and assessment of structural and functional properties of erythrocytes, leucocytes and platelets.


laboratoriesAccording to WHO 2008 following markers are used to assign lineage

Myeloid lineage

t MPO positivity or

t Monocytic differentiation (at least 2 of NSE, CD11c, CD14, CD64, lysozyme)

T lineage

t Cytoplasmic CD3 or surface CD3

B lineage

t Strong CD19 with at least one of the following strongly expressed: CD79a, cCD22, CD10

t Weak CD19 with at least two of the following strongly expressed: CD79a, cCD22, CD10

Some commonly used antigens for flowcytometric evaluation

t B cell Markers: - CD19, CD 20, CD22, sIg M, CD79a

t T cell Markers: - CD3, CD4, CD5, CD7, CD8, cyCD3

t Myeloid & Monocytic markers: - CD13, CD33, CD14, CD36, CD64, CD11b, MPO, CD11c

t Erythroid: - CD235a (Glycophorin A), CD71,

t Megakaryocytic: - CD41, CD61

t Immaturity markers – CD34, HLDR and TdT

t Plasma cells – CD38, CD138


Why choose Oncquest?

NABL & CAP accredited, state –of- the- art Super Specialty Clinical Diagnostics Laboratory.

Specialized Laboratory centers located at New Delhi, Mumbai, Bangalore, Hyderabad, Indore and Ludhiana.

Extensive network of 1000+ collection centers with operations across India and South Asia.

Largest number of College of American Pathologists(CAP) certified auditors working in- house.

World class facility with 8 color BD FACS Canto II instruments for high sensitivity testing of small populations.

Highest number of MRD Testing performed every year.

Dedicated team of experienced doctors.

One to one interaction with referring doctor for all critical cancer.

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What are the medical indications for Flowcytometry?As per the Bethesda International Consensus 2006, recommendations on the medical indications for diagnostic Flowcytometry in hematolymphoid neoplasms are as follows-

(In each instance, it is assumed that a hematolymphoid neoplasm is suspected based on clinical or pathological findings and other causes for the abnormality e.g. nutritional deficiency, infection, drug reaction or autoimmunity have been ruled out.)

Cytopenias – especially pancytopenia, however as isolated anemia commonly occurs in non-neoplastic diseases, it should not automatically trigger flowcytometry testing.

Elevated leucocyte count-

Differential diagnosis of a lymphocytosis include reactive conditions, CLL and other CLPDs. Monocytosis may be seen with CMML or occasionally other MPDs and FCM may be helpful in distinguishing them from reactive monocytes. Eosinophilia may be the first indication of AML, mastocytosis, ALL or T CLPDs.

Observation of a typical cells or blasts in blood/marrow /fluids

FCM confirms that the atypical cells are blasts and plays an important role in the diagnosis and classification of acute leukemia; it is also indicated in the evaluation of atypical mononuclear cells in body fluids to rule out reactive activated lymphoid cells and detect possible neoplasm.

Plasmacytosis or Monoclonal Gammapathy

FCM is useful in diagnostic evaluation of unexplained marrow plasmacytosis by assessing phenotypically aberrant or clonal plasma cells and its ability to detect other underlying monoclonal B cell processes.

FCM is generally not indicated in the following conditions because they are usually not associated with hematolymphoid malignancy or associated with hematolymphoid neoplasm that is not detectable by FCM.

Mature Neutrophilia Polyclonal Hypergammaglobulinemia Polycythemia Thrombocytosis Basophilia


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Patient monitoring indications for Flowcytometry testing

Once initial diagnosis of hematolymphoid neoplasm is given, additional FCM testing may be performed. Indications for testing in this setting are as follows-

Staging disease to document the extent of involvement. Flowcytometry is much more sensitive than conventional morphology for detecting disease in bone marrow or blood.

Assessment of response to therapy including MRD

MRD positivity predicts increased risk of relapse and is often an adverse prognostic factor.

Documentation of progression or relapse

Diagnosis of additional inter current hematolymphoid neoplasm, either treatment related (therapy related myeloid neoplasm or PTLD) or coincidental.

Evaluation of disease acceleration (e.g CML blast crisis) or transformation( e.g DL BCL in low grade lymphoma or CLL)

Prognostication especially in CLL with the detection of ZAP 70 or CD38, Acute Leukemia etc.

Detecting potential therapeutic targets e.g CD20.


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1. Clinical Diagnosis

Acute Leukemia

Acute Leukemia comprehensive

diagnosis

(FCM workup of B-ALL/T-ALL/AML with

subtyping)

Acute Leukemia Basic Lineage

B-ALL/T-ALL/AML, No subtyping or

Cytoplasmic Markers included

Acute Leukemia Orientation Panel

B-ALL/T-ALL/AML no subtyping, but lineage

specific markers included

Which Leukemia Flowcytometry panel to choose?

2.Clinical Diagnosis

Leukemia /Lymphoma or Lymphoma /Myeloma

Leukemia lymphoma comprehensive diagnosis panel

{Open panel with stepwise workup to pinpoint diagnosis with subtyping}


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3.Clinical Diagnosis

CLL /LYMPHOMA

CLL Comprehensive Panel

Complete workup of B/T CLPDs with CLL

prognostic marker ZAP 70 included

Lymphoma panel

Complete work up of B/T CLPDs.

(ZAP 70 not included)

Basic B CLL Screening Panel

For confirmation of B CLL

(Zap 70 not included. Other B/T CLPDs will require up gradation

to lymphoma panel for subtyping )


1. Acute Leukemia Comprehensive Diagnosis

The panel is designed to classify acute leukemia into ALL or AML with further subtyping.

Cytoplasmic lineage specific markers are included.

ALCD panel includes - B cell markers : CD19, CD20, CD22, sIgM, T cell markers : CD3, CD4, CD5, CD7, CD8, CyCD3, Myeloid & Monocytic markers : CD13, CD14, CD16, CD33, CD36, CD64,

CD11b, MPO, Others : CD10, CD34, TdT, HLA DR, CD45, CD117

Test Details:

Test code Test Name Technology Sample Type Reported on

SP10065

Flowcytometry - Acute Leukemia Comprehensive

Diagnosis

Flow Cytometry

2ml whole blood /Bone Marrow in Sod.

Heparin tubes.

Next Working Day if received before

1400 Hrs.

ACUTE LEUKEMIA PANELS

Recommended additional testing-

B ALL cases- Karyotyping and ALL Translocation panel for t(9;22),t(12;21),t(1;19) and t(4;11)

AML cases-Karyotyping and molecular testing for AML ETO,inv16, PML RARa, MLL, FLT3,NPM, CEBPA mutations

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2. Acute Leukemia –T, B or Myeloid Panel

Classifies acute leukemia into ALL or AML.

Cytoplasmic Lineage specific markers are not included.

The panel includes - B cell markers: CD19, CD22, T cell markers : CD3, CD5, CD7, Myeloid markers : CD13, CD33, Others : CD10, CD34, CD45, HLA DR, CD117.


SP10066

Flowcytometry - Acute

Leukemia -T, B or Myeloid

Flow Cytometry

2ml whole blood /Bone Marrow in Sod. Heparin

tubes.

Next Working Day if received before 1400

Hrs.

3. Acute leukemia orientation Panel

The panel is designed to classify acute leukemia into ALL or AML.

Cytoplasmic lineage specific markers are included.

The panel includes- B cell markers: CD19, CD22, T-cell markers : CD3, CD5, CD7, CyCD3, Myeloid markers: CD33, MPO, Others: CD10, CD34, CD117, CD45


SP10089Flowcytometry

- Leukemia Orientation panel

Flow Cytometry

2ml whole blood /Bone

Marrow in Sod. Heparin tubes.

Next Working Day

if received before

1400 Hrs.

Test Details:

Test Details:

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4. AML Characterization Panel

The panel is designed for subtyping of confirmed AML cases.

The panel includes - B cell marker: CD19, T cell marker: CD7, Myeloid & monocytic markers : CD13, CD14, CD16, CD33, CD36, CD64, CD11b, MPO, Others: CD117, CD34, HLA DR, CD45

Test Details:

Test Details:

Test code Test name Specimen Requirement

Technique Reported on

SP10067 Flowcytometry - AML

Characterization Panel


tubes.

Flow Cytometry


1400 Hrs.

Recommended additional testing-Karyotyping and molecular studies for AML ETO, inv16, PML RARa,MLL,FLT3,NPM and CEBPA mutation.

5. ALL Characterization Panel ALL panel is designed to distinguishing ALL from acute myelogenous

leukemia (AML) and chronic lymphoproliferative, and for further subtyping of confirmed ALL cases.

The panel includes- B cell markers: CD19, CD20, sIgM, T cell markers : CD3, CD4, CD5, CD7, CD8, CyCD3, Others : CD10, CD34, CD38, CD45, TdT

Test Code

Test name Specimen Requirement


SP10068 Flowcytometry - ALL

Characterization Panel


tubes.

Flow Cytometry


1400 Hrs.

Recommended additional testing- Karyotyping and for B ALL cases, ALL translocation panel for t(9;22), t(12;21), t(1;19) and t(4;11)

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Test Details:


SP10075

Acute Leukemia - MRD Panel

(MRD & Relapse) (Flowcytometry)

Flow Cytometry

(2-4)ml Bone Marrow in

Sodium Heparin anticoagulated

tube preferred /EDTA

3rd Working Day if

received before

1400 Hrs.

As per NCCN guidelines version 3.2013 the recommendation for timing of MRD assessment in B ALL is-

Upon Completion of initial induction

Additional time points may be useful depending on the regimen used.

Minimal Residual Diagnosis (MRD) Panel

MRD refers to the presence of leukemic cells below the threshold of detection by conventional morphology. Its significance is that it predicts increased risk of relapse or has been indicated in almost all studies. However, there is some variation on exact time points in various clinical trials.

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Test Details:

Test code Test name Specimen Requirement Technique TAT/Reported

on

SP10069

Flowcytometry - CLL Diagnostic

Panel (Comprehensive)

2ml whole blood /Bone Marrow in

Sodium Heparin tubes.

Flow Cytometry

Next Working Day if

received before 1400

Hrs.

SFC10049 ZAP 70 (Flowcytometry)


Sodium Heparin tubes.

Flow Cytometry

Next Working Day if


Hrs.

CHRONIC LYMPHOPROLIFERATIVE DISORDER (CLPD) PANELS

1. CLL Diagnostic Panel

The panel is designed for the confirmation and subtyping of CLPDS.

CLL Panel includes T-cell Markers :CD2, CD3, CD4, CD5, CD7, CD8,

B-cell Markers : CD19, CD20, CD23, CD79b, CD200, SIgM, Kappa, Lambda, FMC-7, Others :CD10,CD25, CD38, CD103, CD11c, CD45, HLADR, ZAP-70

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Recommended additional testing- CLL Target gene analysis by FISH and Ig VH Somatic hypermutation assay for prognostication in CLL cases.

Cyclin D1 by FISH in suspected Mantle Cell Lymphoma cases.


2. LYMPHOMA PANEL

Lymphoma panel give confirmation and subtyping of CLPDs.

The panel includes - T- cell Markers: CD2,CD3,CD4,CD5,CD7,CD8. B-cell Markers: CD19,CD20,CD23,CD79b, CD200, SIgM, Kappa,Lambda,

FMC-7. Others: CD10, CD25, CD103, CD11c, CD45, HLADR.

Test Details:



- Lymphoma Diagnostic Panel

Flow Cytometry

2ml whole blood /Bone

Marrow in Sod. Heparin tubes.

Next Working Day if


Hrs.

3. HAIRY CELL LEUKEMIA PANEL

Hairy Cell Leukemia is a clonal B-cell malignancy caused due to the abnormal growth of B cells which develop hair like cytoplasmic projections on the surface and look “hairy” under a microscope.

The panel is meant for confirmation of Hairy cell leukemia.

The pannel includes : CD19, CD20, Kappa, Lambda, CD25, CD103, CD11c, HLADR, CD45

Test code Test name Specimen Requirement


SP10073Hairy Cell

Leukemia Panel (Flowcytometry)


Sod. Heparin tubes.

Flow Cytometry

Next Working Day if


Hrs.

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Test Details:

Test Details:

Test code

Test name Specimen Requirement


SP10074 Multiple Myeloma Panel

Bone Marrow in Sod.

Heparin tubes.

Flow Cytometry

Next Working Day if received

before 1400 Hrs.

Recommended additional testing- Multiple Myeloma panel by FISH,Del17p by FISH.

LEUKEMIA LYMPHOMA COMPREHENSIVE DIAGNOSIS PANEL

Open panel for cases in which diagnosis of acute leukemia vs CLPDs is not clear on morphology or clinical findings.

Stepwise approach is taken and comprehensive diagnosis is given.

MULTIPLE MYELOMA PANEL

Multiple myeloma (MM) is a plasma cell neoplasm characterized by proliferation of monoclonal plasma cells.

MM panel is for confirmation of clonality and abnormal antigen expression in neoplastic plasma cells.

MM pannel includes-CD19, CD20 CD38, CD45, CD56, CD138, Cy.Kappa, Cy.Lambda


SP10088

Flowcytometry - Leukemia Lymphoma

Comprehensive Diagnosis panel

Flow Cytometry


Sod. Heparin tubes.


before 1400 Hrs.

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PAROXYSMAL NOCTURNAL HEMOGLOBINURIA(PNH)

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare stem cell disorder characterized by the triad of intravascular hemolysis, peripheral blood cytopenias due to bone marrow failure and predisposition to venous thrombosis.

The acquired defect in PNH is the loss of Glycosylphosphatidylinositol (GPI) anchored protein expression by hematopoietic stem cells. GPI linked Epitopes are easily detected on peripheral blood cells and can be accurately evaluated by Flowcytometry.

Recommendations for clinical indications for PNH screening are-

Intravascular hemolysis with hemoglobinuria

Thrombosis involving unusual sites such as hepatic, portal, splanchnic or splenic veins, dermal veins or cerebral veins.

Bone marrow failure with marrow hypoplasia, unilineage dysplasia or unexplained peripheral cytopenias.

The early approach to flowcytometric diagnosis was through the assessment of CD55 and CD59 as these were the first antigens reported to be regularly lost on the red cells and leucocytes of PNH patients.

FLAER (Fluorescent Aerolysin) is more reliable for detection of PNH clones as it shows a high sensitivity and specificity in defining GPI deficient cells and is able to detect very small clones in patients with Aplastic Anemia.

It is recommended that at least two GPI linked markers including FLAER are used to assess PNH clones.

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SP10084

Flowcytometry - PNH

Comprehensive Work Up

Flow Cytometry

2ml whole blood in

Sod. Heparin tubes.


before 1400 Hrs.

SP10071

Flowcytometry - PNH

Diagnostic Panel (Polymorphs)

Flow Cytometry

2ml whole blood in

Sod. Heparin tubes.


before 1400 Hrs.

SP10070

Flowcytometry - PNH

Diagnostic Panel(RBCs)

Flow Cytometry

2ml whole blood in

Sod. Heparin tubes.


before 1400 Hrs.


- PNH With Flaer

Flow Cytometry

2ml whole blood in

Sod. Heparin tubes.


before 1400 Hrs.

Test Details:

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Test Details:


SP10076CD4/ CD8

Enumeration (Flowcytometry)

Flow Cytometry


Sod. Heparin tubes.


before 1400 Hrs.

SP10077Flowcytometry - Helper CD4 Cells

Enumeration

Flow Cytometry

2ml whole blood in

EDTA tubes.


before 1400 Hrs.

CD 34 QUEST

The hematopoietic stem cells(HSCs) in marrow and peripheral blood which are responsible for multilineage engraftment in the transplant setting express the cell surface marker CD34 .

Flowcytometry enumeration of CD34 cells provides a rapid means of measuring the clinically useful surrogate marker of graft adequacy in all sources of HSCs.


SP10078

Flowcytometry - CD34quest

(Ishage Gating)

Flow Cytometry

2ml whole blood /Bone Marrow

in Sod. Heparin tubes.


Hrs.

Test Details:

CD4/CD8 ENUMERATION

The CD4/CD8 ratio is a reflection of immune system .

The enumeration of CD4 and CD8 positive cells, surrogate markers for HIV disease progression, is helpful in management and follow up of immunocompromised HIV positive patients.

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T -B -NK CELL PANEL T-cells are involved in combating intracellular infections, cancer

cells, and foreign tissue, B-cells give rise to the humoral immune system and NK cells play a role in defense against viral infections and tumors.

These lymphocyte subsets can be discerned by the antigenic properties of cell surface (membrane) markers

The panel is used to assess the immune status of patients .

Test Details:

HLA B-27 The presence of HLA B-27 antigen by Flowcytometry is strongly associated

with Ankylosing spondylitis, a chronic inflammatory disease of the axial musculoskeletal system and a few other rheumatic disorders (Reiter’s syndrome, Acute anterior uveitis and Inflammatory Bowel disease).

HLA-B2-7 testing is routinely used to screen for Ankylosing spondylitis, since 90% of patients with Ankylosing spondylitis have the HLA B2-7 surface antigen compared to only 8% of healthy individuals.

Test code Test Name Technology Sample Type TAT/Reported on

SP10096

Flowcytometry - T B NK cell lymphocytes

subset analysis

Flow Cytometry

2ml whole blood in Sod. Heparin/

EDTA tubes.


Hrs.

Test Details:

Test Code Test Name Technique Instructions for Sample Collection

TAT / Reported

on

SFC10056 HLA B-27 Flow Cytometry

DO NOT FREEZE. Please specify-Date and time of sample withdrawn; Detailed clinical history; Date of Chemotherapy (if

Possible)


Hrs.

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Test Details:

FLOW CYTOMETRY IN SOLID TUMORSDNA PLOIDY AND CELL CYCLE

The prognosis of malignancies like breast cancer etc is determined by DNA ploidy and Cell cycle.

The panel analyses the proliferative potential of cancer cells by measuring the number of cells actively synthesizing DNA(S phase fraction (SPF).

Higher SPF is associated with worse prognosis.

Test code

Test name Specimen Requirement Technique Reported on

SFC10053

DNA Ploidy & S- Phase,

Solid Tumours

Paraffin embedded tissue block or Formalin Fixed

Tissue OR

0.5g Fresh tissue sent in RPMI 1640. Transport at

8-10°C.

Flow Cytometry


before 1400 Hrs.

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Recd. Dt. Tm.: 01/12/2014 16:51:15 Client Details: CAPRegd. Date: 01/12/2014 College of AmericanPathologist, NorthfieldName: Mr. Dummy Ref. By: Not SpecifiedAge: Sex: MaleAccession ID: 5014465 Printed Date: 01/12/2014

FLOW CYTOMETRY REPORT

Test Name Result Unit Biological Ref. Interval

Acute Leukemia Comprehensive Diagnosis

T-cell Markers XX % of Gated Leukocytes

CD3 XX % of Gated Leukocytes

Cyt.CD3 XX % of Gated Leukocytes



CD 7 XX %of Gated Leukocytes


B-cell Markers


CD 10 XX % of Gated Leukocytes



SIgM XX % of Gated Leukocytes

Myeloid/Monocytic Markers XX

CD13




Others XX % of Gated Leukocytes

DUMMY REPORTS

To be continued ...







CD11b XX % of Gated Leukocytes


HLADR XX % of Gated Leukocytes

MPO XX % of Gated Leukocytes

TdT XX % of Gated Leukocytes


Interpretation of Observations

Specimen type: - Bone Marrow/Peripheral blood showed TLC – xxxx cells/µl.

SSC Vs CDxx Gating.

Gated leukocytes in blast (xx% of Acquired Events) region are highly positive for CDxx, CDxx, CDxx, moderately positive for CDxx, CDxx, CDxx, and rest of the markers are negative.

Impression

The scatter parameters and antigen expression profiles as studied by flow cytometry of the sample are suggestive of XXXX.

Aberrancy detected: CDxx

Correlation with clinical, cytogenetic and other hematological parameters is advised.

***** End of the Report *****

The sample is processed by Oncquest Laboratories Ltd.

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Acute Leukemia- MRD Panel (MRD & Relapse)


MRD Analysis done by Flow Cytometry.

Markers used are (CDxx, CDxx, CDxx, CDxx, CDxx, CDxx, CDxx, CDxx, CDxx, CDxx, CDxx, CDxx ) in 8 color panels in various combinations.

CLINICAL DETAILS:

ALL on chemo.

Previous Immunophenotype: B – ALL (Relapse)

Sample time point: xxxx

SPECIMEN:

Bone marrow showed TLC = xxxx cells/µl.

FLOWCYTOMETRY ANALYSIS:

Instrument/Software: BD FACS Canto II /BD FACS DIVA

Cell Preparation Method: Lyse- Wash- Stain- Wash

Gating strategy: FSC Vs S =SC, SSC Vs CDxx and SSC Vs CDxx

Total events acquired/ per tube = xxxxxxx cells / tube

Abnormal events = xxxx

DUMMY REPORTS

To be continued ...


B-ALL residual blasts = xxxx% of Total Acquired events

IMPRESSION:

B-ALL MRD = xxxx% of Total Acquired events

Please correlate with previous hematological, immunophenotypic reports, detailed clinical/ancillary inputs and exact day of chemotherapy.





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CLL DIAGNOSTIC PANEL (COMPREHENSIVE)


T-cell Markers

CD2 XX % of Gated LeukocytesCD3 XX % of Gated LeukocytesCD4 XX % of Gated LeukocytesCD5 XX % of Gated Leukocytes CD7 XX % of Gated LeukocytesCD8 XX % of Gated Leukocytes B-cell MarkersCD19 XX % of Gated LeukocytesCD20 XX % of Gated LeukocytesCD79b XX % of Gated LeukocytesCD23 XX % of Gated LeukocytesCD200 XX % of Gated LeukocytesFMC-7 XX % of Gated LeukocytesSIgM XX % of Gated LeukocytesKappa XX % of Gated LeukocytesLambda XX % of Gated LeukocytesCD19+ZAP-70 XX % of Gated LeukocytesCD19+CD5 XX % of Gated LeukocytesCD19+CD38 XX % of Gated LeukocytesOthersCD10 XX % of Gated Leukocytes CD25 XX % of Gated LeukocytesCD38 XX % of Gated LeukocytesCD16 XX % of Gated LeukocytesCD11c XX % of Gated Leukocytes

DUMMY REPORTS

To be continued ...


CD103 XX % of Gated LeukocytesCD45 XX % of Gated LeukocytesCD56 XX % of Gated LeukocytesHLADR XX % of Gated LeukocytesZAP-70 XX % of Gated LeukocytesCD XX % of Gated Leukocytes

CD XX % of Gated Leukocytes


Specimen type: - Bone Marrow/Peripheral blood sample showed TLC-xxxx cells/µl.

SSC Vs CD19/CD20 Gating.

Flow cytometric analysis shows xx% of atypical B- Lymphoid cells with:

And rest of the markers are negative.

Impression

The scatter parameters and antigen expression profile as studied by flow cytometry of

the sample are suggestive of xxxx.



Bright expression of CDxx, CDxx, CDxx

Dim expression of CDxx, CDxx

Moderate expression of CDxx, CDxx

Heterogeneous expression of CDxx

CLL DIAGNOSTIC PANEL (COMPREHENSIVE)


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MULTIPLE MYELOMA PANEL


B-cell Markers xx % of Gated Leukocytes

CD19 xx % of Gated Leukocytes Cy. Kappa xx % of Gated LeukocytesCy. Lambda xx % of Gated LeukocytesOthers xx % of Gated LeukocytesCD38 xx % of Gated LeukocytesCD56 xx % of Gated LeukocytesCD138 xx % of Gated Leukocytes

CD45 xx % of Gated Leukocytes

Interpretation of Observation

Specimen Type: - Bone marrow sample showed TLC-xxxx cells/µl.

SSC Vs CDxx Gating.

Flow cytometric analysis shows xx% atypical cells expressing CDxx, CDxx, CDxx and

negative for CDxx, CDxx.

Impression

The scatter parameters and antigen expression profile as studied by flow cytometry of

the sample are suggestive of xxxxx.

Correlation with clinical, cytogenetic and other hematological parameters is advised.



DUMMY REPORTS


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Notes

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Notes


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Notes

Regd. Office & Central Laboratory: 3 - Factory Road, Adjacent Safdarjung Hospital, New Delhi - 110029

Tel.: 91-11-30611432, 30611467 Fax: 011-26182231 Email: [email protected] Web: www.oncquest.net Oncquestlaboratories

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