Flow Cytometry In The Differential Diagnosıs Of Neutropenic Patients

Abstract

Introduction: Although immuno-phenotyping with flow cytometry is mainly used in the diagnosis of hematological neoplasia, it also provides important contributions to revealing changes in the immune system. Flow cytometric studies are also frequently performed in neutropenic patients, as changes in neutrophil count may occur in relation to hematological neoplasms and immune system disorders.

Objective: Within the scope of this study, we aimed to elucidate the expressions of lymphocyte, granulocyte, and monocyte subtypes and myelomonocytic antigens on monocytes and neutrophils in neutropenia caused by different reasons and compare them with the results of healthy volunteers.

Method: A total of 24 patients and 13 age-and gender-matched healthy volunteers who applied to our institution have been enrolled in this study. The patient group consisted of individuals with isolated neutropenia. Examination findings, lymph node size, spleen size, and infection findings,and the laboratory parameters, CRP level, and pathological findings in the peripheral smear were recorded. Total blood obtained from the patients has been processed with flow cytometry.

Results: Neutrophil/lymphocyte (N/L) MFI ratio was found to be higher in the patient group than in the control group (p=0.022).A positive correlation was found between leukocyte counts and the percentage of atypical monocyte expressing CD16 (p=0.033). A negative correlation was found between platelet counts and N/L mean fluorescence intensity ratio (p=0.411) and between the platelet count and the percentage of CD11b on neutrophils (p=0.026). The percentage of neutrophils determined on leukocytes and the percentage of natural killer cells (CD30/CD56+) was statistically significantly lower in the patient group (p=0.008, p=0.001 respectively).

Conclusion: Regarding the results of this study one could say that clinically significant changes have been observed in lymphocyte and monocyte subtypes of patients with isolated neutropenia. Granulation was found in the ratio of N/L side scatter, mostly related to neutrophils.