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1. Chronic lymphocytic leukaemia Australasian consensus practice statement.

Author

Anderson, Mary A., Bennett, Rory, Badoux, Xavier, Best, Giles, Chia, Nicole, Cochrane, Tara, Cull, Gavin, Crassini, Kyle, Harrup, Rosemary, Jackson, Sharon, Kuss, Bryone, Lasica, Masa, Lew, Thomas E., Marlton, Paula, Opat, Stephen, Palfreyman, Emma, Polizzotto, Mark N., Ratnasingam, Sumita, Seymour, John F., and Soosapilla, Asha

Subjects
CHRONIC lymphocytic leukemia diagnosis, CHRONIC lymphocytic leukemia treatment, CHRONIC lymphocytic leukemia, CONSENSUS (Social sciences), FLOW cytometry, SEQUENCE analysis, HOMOGRAFTS, B cell lymphoma, GENETIC testing, MEDICAL protocols, PROTEIN-tyrosine kinase inhibitors, ANTIBIOTIC prophylaxis, CELLS, ALGORITHMS, DISEASE management, SYMPTOMS
Abstract

Chronic lymphocytic leukaemia (CLL) is the most common haematological malignancy in Australia and New Zealand (ANZ). Considerable changes to diagnostic and management algorithms have occurred within the last decade. The availability of next‐generation sequencing and measurable residual disease assessment by flow cytometry allow for advanced prognostication and response assessments. Novel therapies, including inhibitors of Bruton's tyrosine kinase (BTKi) and B‐cell lymphoma 2 (BCL2) inhibitors, have transformed the treatment landscape for both treatment‐naïve and relapsed/refractory disease, particularly for patients with high‐risk genetic aberrations. Recommendations regarding appropriate supportive management continue to evolve, and special considerations are required for patients with CLL with respect to the global SARS‐CoV‐2 pandemic. The unique funding and treatment environments in Australasia highlight the need for specific local guidance with respect to the investigation and management of CLL. This consensus practice statement was developed by a broadly representative group of ANZ experts in CLL with endorsement by peak haematology bodies, with a view to providing this standardised guidance. [ABSTRACT FROM AUTHOR]

Published
2023
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2. Reproducible diagnosis of chronic lymphocytic leukemia by flow cytometry:An European Research Initiative on CLL (ERIC) & European Society for Clinical Cell Analysis (ESCCA) Harmonisation project

Author

Rawstron, AC, Kreuzer, K-A, Soosapilla, A, Spacek, M, Stehlikova, O, Gambell, P, McIver-Brown, N, Villamor, N, Psarra, K, Arroz, M, Milani, R, de la Serna, J, Cedena, MT, Jaksic, O, Nomdedeu, J, Moreno, C, Rigolin, GM, Cuneo, A, Johansen, P, Johnsen, HE, Rosenquist, R, Niemann, CU, Kern, W, Westerman, D, Trneny, M, Mulligan, S, Doubek, M, Pospisilova, S, Hillmen, P, Oscier, D, Hallek, M, Ghia, P, Montserrat, E, Rawstron, Andy C., Kreuzer, Karl-Anton, Soosapilla, Asha, Spacek, Martin, Stehlikova, Olga, Gambell, Peter, McIver-Brown, Neil, Villamor, Neu, Psarra, Katherina, Arroz, Maria, Milani, Raffaella, de la Serna, Javier, Cedena, M. Teresa, Jaksic, Ozren, Nomdedeu, Josep, Moreno, Carol, Rigolin, Gian Matteo, Cuneo, Antonio, Johansen, Preben, Johnsen, Hans E., Rosenquist, Richard, Niemann, Carsten Utoft, Kern, Wolfgang, Westerman, David, Trneny, Marek, Mulligan, Stephen, Doubek, Michael, Pospisilova, Sarka, Hillmen, Peter, Oscier, David, Hallek, Michael, Ghia, Paolo, and Montserrat, Emili

Subjects
chronic lymphocytic leukemia, diagnosis, flow cytometry, 2734, Histology, Cell Biology, Clinical Laboratory Medicine, Reproducibility of Results, Pilot Projects, Original Articles, Leukemia, Lymphocytic, Chronic, B-Cell, NO, Immunophenotyping, diagnosi, Klinisk laboratoriemedicin, immune system diseases, hemic and lymphatic diseases, Biomarkers, Tumor, Humans, Original Article, Retrospective Studies
Abstract

The diagnostic criteria for CLL rely on morphology and immunophenotype. Current approaches have limitations affecting reproducibility and there is no consensus on the role of new markers. The aim of this project was to identify reproducible criteria and consensus on markers recommended for the diagnosis of CLL. ERIC/ESCCA members classified 14 of 35 potential markers as “required” or “recommended” for CLL diagnosis, consensus being defined as >75% and >50% agreement, respectively. An approach to validate “required” markers using normal peripheral blood was developed. Responses were received from 150 participants with a diagnostic workload >20 CLL cases per week in 23/150 (15%), 5–20 in 82/150 (55%), and 97% concordance with current approaches. A pilot study to validate staining quality was completed in 11 centers. Markers considered as “required” for the diagnosis of CLL by the participants in this study (CD19, CD5, CD20, CD23, Kappa, and Lambda) are consistent with current diagnostic criteria and practice. Importantly, a reproducible approach to validate and apply these markers in individual laboratories has been identified. Finally, a consensus “recommended” panel of markers to refine diagnosis in borderline cases (CD43, CD79b, CD81, CD200, CD10, and ROR1) has been defined and will be prospectively evaluated. © 2017 International Clinical Cytometry Society.

Published
2018
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