Study: Atypical CLL Identified by Digital Microscopy

Using digital imaging to identify patients with atypical CLL (aCLL) is feasible, economical, and may provide clinically relevant prognostic information at diagnosis and during periodic monitoring according to a new study by Steven Marionneaux at Memorial Sloan Kettering Cancer Center, New York, NY.

Steven Marionneaux
Steven Marionneaux is Manager at the Clinical Hematology Laboratories, Memorial Sloan Kettering Cancer Center, New York, NY.

Some insights from the study include:
27% of CLL cases were morphologically classified as atypical CLL. The aCLL group had a higher prevalence of trisomy 12, unmutated IgVH, and CD38 expression (markers associated with poor prognosis), and a lower prevalence of 13q14 deletion compared to typical CLL.

Traditional microscopic assessment of lymphocytes involves counting cells one at a time with limited opportunity for cell-to-cell comparison. Subclassification into prolymphocytes, large atypical forms, or cleaved cells requires additional time and a higher level of expertise due to morphologic variation within and between patients. Digital imaging technology enabled easier identification due to the simultaneous display of cells on a high-definition wide screen monitor and resulted in a faster and more objective classification and enumeration of lymphocyte subtypes. In addition, the images can be archived for second review and easily compared with previous results.

The study was recently published in the International Journal of Laboratory Hematology. Article first published online: 25 NOV 2013 DOI: 10.1111/ijlh.12167.

Link to abstract and full story at publisher’s website
Morphologic identification of atypical chronic lymphocytic leukemia by digital microscopy

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