Immunophenotyping is used primarily to help diagnose and classify the blood cell cancers, leukemias and lymphomas, and to help guide their treatment. It may be ordered as a follow-up test when a complete blood count (CBC) and differential show an increased number of lymphocytes and the presence of immature blood cells or when there is a significant increase or decrease in the number of platelets (thrombocytosis or thrombocytopenia).
Samples are analyzed using various panels of antibodies that have been established for various types of leukemia or lymphoma. For example, each of these cancers would have a pre-defined panel of antibodies that would be consistent with their diagnosis: acute lymphoblastic leukemia, acute myeloid leukemia, hairy cell leukemia, erythroleukemia, B-cell lymphoma, or T-cell lymphoma.
Typically, a health practitioner will provide information about an individual who they suspect has leukemia or lymphoma. Basic testing of a CBC, differential, and platelet count would be performed in addition to immunophenotyping. The antigen selection, or panel, is made based upon that information.
Testing may sometimes be performed to evaluate the effectiveness of leukemia or lymphoma treatment and to detect residual or recurrent disease by observing the continued presence of abnormal cells.
Immunophenotyping may be ordered when a person has an increased number of lymphocytes (or sometimes an increase in another type of white blood cell (WBC)), an increased or decreased platelet count, or has immature WBCs that are not normally seen in blood. These are usually findings from a complete blood count (CBC) and differential and may be the first indication that a person might have a blood cell cancer. Symptoms of early leukemia and lymphoma may be unremarkable, mild, or nonspecific.
The presence of certain antigens that are identified by immunophenotyping require expertise to interpret. A pathologist, often one specializing in the study of blood diseases and/or blood cell cancers (a hematopathologist), will consider the results from the complete blood count (CBC), differential, blood smear, bone marrow findings, and immunophenotyping as well as other tests in order to provide a diagnostic interpretation. A laboratory report will typically include specific results from the tests as well as an analysis of what those results mean.
The markers that are present on the cells as detected by immunophenotyping will help characterize the abnormal cells present (if any). This information is considered together with the affected person's clinical history, physical examination, signs and symptoms as well as all laboratory tests to help make a diagnosis.
(For more on diagnosis in blood cell cancers, see the College of American Pathologists web site, MyBiopsy.org.)
It must be kept in mind that while findings represent comparisons to "normal" results and to known antigen associations with leukemias and lymphomas, each person's condition will also be unique. A person may have (or lack) certain antigens that are typically seen, yet still be diagnosed with a specific type of leukemia or lymphoma.
Abnormal immunophenotype profiles are usually present in: acute myelogenous leukemia (or acute myeloid leukemia), acute lymphoblastic leukemia, chronic lymphocytic or myelocytic leukemias, B-cell and T-cell non-Hodgkin lymphomas, erythroleukemia (RBC leukemia), megaloblastic leukemia (platelets), and multiple myeloma.
Markers that are often expressed in certain type of cells:
This article was last reviewed on December 29, 2014. | This article was last modified on December 30, 2014.
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