FLAER Based Assay According to Newer Guidelines Increases Sensitivity of PNH Clone Detection

In this study, the abnormal PNH clones were detected using a single tube FLAER based testing and two tubes non-FLAER based testing in all cases of PNH (n = 12), healthy subjects (n = 18) and AA/MDS with PNH clone (n = 9) and compared with clinical and laboratory features at di agnosis. The receiver operator curve (ROC) analysis defined the optimal cut-offs for FLAER in granulocytes (>  0.7%) and monocytes (>  0.9%). There was significant positive correlation between FLAER and non-FLAER based testing in these cells (r >  0.3 andp <  0.05). FLAER based testing helped us in picking up smaller clones which were missed by latter technique in four patients thereby increasing its sensitivity and also technically proved to be cost-effective (Rs. 1800 vs. Rs. 2100). Even in PNH patients, the clone size was slightly higher by using F LAER when compared to non-FLAER based antibodies panel. The clone size of monocytes was always higher than granulocytes in both PNH and AA/MDS groups. Bone marrow cellularity and mean size of granulocytes and monocytes clone at diagnosis showed a striking statistically significant ‘p’ value of <  0.0001 between these groups. In this pilot study, a single tube FLAER based PNH testing had improved clone detection in all cases of PNH, AA/MDS with PNH clones. The clone size was >  30% in majority of PNH cases whereas in AA/MDS, it was usually <  10% at diagnosis. Hence this newer technique not only i...
Source: Indian Journal of Hematology and Blood Transfusion - Category: Hematology Source Type: research