Conference App Publication Indian Ocean Rim Laboratory Haematology Congress 2014

Role of peroxidase activity and nuclear density analysis (PANDA) score in hematologic malignancies using a hematology cell counter (#45)

Komal Mahesh Deshmukh 1 , Shilpa S. Kushte 1 , Nilesh D. Deshpande 1 , Leena S. Fernandes 1 , Neha Mittal 1 , P.G. Subramanian 1 , Sumeet Gujral 1
  1. Hematopathology Laboratory, Tata Memorial Hospital, Mumbai, Maharashtra, India

Diagnosis of hematological malignancies involves smear morphology alongwith various ancillary techniques. Automated hematology cell counter ADVIA 2120i generates different analytic profiles for various malignancies. We studied its role in sub-typing of hematological malignancies based on cytograms from the peroxidase and nuclear density channels indicated as PANDA score. PANDA scores were noted for blood samples of 129 newly registered cases of suspected leukemia, blinded to the final diagnosis of that case. These cases were initially evaluated on peripheral blood smear. Acute leukemia (n=98) demonstrated abnormal cell populations in large unstained cells in peroxidase channel and blast regions in  baso/lobularity channel. It included acute myeloid leukemia (n=55) showing P1-P6 D1 score and acute lymphoblastic leukemia (n=43) with P0D1 score. Chronic myeloid leukemia (n=21) showed a dense distribution of varying cellular maturity on the perox cytogram along with basophilia - P5D1 score. Chronic lymphocytic leukemia (n=6) and Non Hodgkin lymphoma (n=3) had P0D0 score. However normal plots were obtained in 7 cases each of ALL and AML (n=14).  PANDA score may help in triage of acute leukemia cases. PANDA score does appear to have value as a preliminary guide that may allow a more focused approach  for further Immunophenotyping and towards subsequent diagnosis.