Evaluation of Clonality in Patients with B-cell Lymphoid Malignancies by Immunohistochemistry Panel and Flow Cytometry Analysis

Abstract

Objective: To assess various methods for clonality detection in patients with B-cell lymphoblastic leukemia.

Study Design: Descriptive diagnostic study
Place and Duration of Study: This study was conducted at the Department of Pathology and Forensic Medicine, Faculty of Medicine, University of Kufa, from October 2023 to June 2024.

Methods: This descriptive diagnostic study was carried out with cases (67 patients) sourced from the Hematology Department of Baghdad Medical City/Educational Lab. Diagnoses were based on the gold-standard flow cytometry test for B-cell acute lymphoblastic leukemia. Age, gender, clinical features, complete blood count, blood smear, and bone marrow morphology reports were collected. Cytochemical tests (Periodic acid-Schiff & Sudan Black B) were performed on fresh bone marrow aspirates.

Results: The mean patient age was 30.74 years, with a male-to-female ratio of 1:2.04. Cytochemical tests, Sudan Black B exhibited high specificity (100%), while periodic acid-Schiff had high sensitivity (65.67%).

Conclusion: The Periodic acid-Schiff cytochemical test, with its high sensitivity, offers valuable diagnostic utility in low-resource laboratories lacking access to immunohistochemistry and flow cytometry.