This section provides a collection of a consensus-based cell library of meaningful hematopoietic images provided, identified and named by members of the European Morphology Faculty, including 28 experts from 17 different European countries. In this cell collection of 228 pictures there are 604 labelled hematopoietic cells and an excel file where each cell is identified by its code on the images, by the type of stain used, the lineage and the consensual name agreed upon by the ELN Diagnosis Morphology Faculty. From May 2007 on, each Faculty member first submitted a set of images. After several rounds of electronic circulation of digitalized pictures, the Faculty reached full agreement for 348 cells, while the agreement on the remaining 256 cells (highlighted with a red circle on the web site) was pending. The latter was reached after a 2-full-day meeting in October 2008. This cell library is the first ELN European tool to train and test European morphologists, aiming to provide a harmonized consensus-name to single hematopoietic cells according to morphological features as seen in light microscopy. The next step of this project will consist in creating a new Faculty with the aim to provide clinical cases as diagnosis pathways, starting from peripheral blood to the final diagnosis and prognosis and according to consensus diagnostic guidelines. The goal is to stratify onco-hematologic patients at diagnosis according to harmonized practices all over Europe. -TABLE AT THE BOTTOM OF THIS PAGE AFTER IMAGES- Faculty chair: Zini G. (IT) Faculty members: Bain B. (UK), Bettelheim P. (AT), Bodil LP (DK), Browne P. (IR), Brusselmans C.(BE), Castoldi GL. (IT), Cortes J. (PT), Csomor J (HU), d’Onofrio G. (IT), Faber E. (CZ), Giagounidis A. (DE), Haferlach T. (DE), Kacirkowa P. (CZ), Lewandowski K. (PL), Liso V. (IT), Matutes E. (UK), Maynadié M. (FR), Meletis J (GR), Porwit A. (SE), Ribeiro M.L. (PT), Sretér L. (HU), Terpos E. (GR), Tichelli A. (CH), Vallespì T. (ES), Urbanska-Rys H. (PL), van ’t Veer M. (NL), Woessner S. (ES).
How can aberrant B lymphoblasts in B lymphoblastic leukemia (B-ALL) be distinguished from hematogones?
Hematogones are immature B-cell precursors that are found primarily in the bone marrow from which they arise. They are found in greatest abundance in infants and young children and decline with age. They are frequently increased in regenerating bone marrow after chemotherapy or bone marrow transplant, but also can be increased in other inflammatory, hematologic, oncologic, and inflammatory disorders. They are rarely detected in peripheral blood. It is particularly important to be able to differentiate hematogones from neoplastic B-cell precursors in the diagnosis and monitoring of B-ALL. B-lineage lymphoblasts and hematogones often share immunophenotypic characteristics. Thus, hematogone hyperplasia can be mistaken for B-ALL at diagnosis and regenerating hematogones can be mistaken for minimal residual disease after therapy. Figure 1A shows normal B-lineage maturation. All hematogones are positive for CD19 (not shown) and show variable expression of CD58. The earliest hematogones...
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