Ross, Ailie (2024) Improving the Diagnostic Accuracy of Haematological Malignancies in Resource-poor Settings. In: [Presented at the Pathology Special Interest Group Meeting]. From: AIMS Tropical Division: Pathology Special Interest Group Meeting (PSIG), 19 June 2024, Townsville, QLD, Australia.

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Abstract

Introduction –Limitations to accessible diagnostic pathology services in RLS influences the diagnosis and treatment of patients with haematological malignancies (HM) like leukaemia and lymphoma. Internationally accepted guidelines and diagnostic criteria are based on access to sophisticated testing including flow cytometry (FC), which is either unavailable or significantly restricted in RLS. The aim of this systematic review is to explore these restrictions, and to identify a more cost-effective minimal FC panel that may be implemented where resources are limited.

Search Strategy – A search was conducted through electronic medical databases for all relevant studies published between 2009 and June 2024. Due to the paucity of data, significantly expanded search terms were used to return enough publications (1005) for exclusion, comparison, and analysis. Included studies and guidelines were assessed for quality, and meta-analyses were performed where possible. General Findings and Trends – 41 studies and guidelines met the inclusion criteria. A review of guidelines showed that there is no consensus for resource-stratified diagnostic protocols including limited FC panels in RLS for acute leukaemia. While a consensus guideline was found for a limited chronic lymphocytic leukaemia FC panel, this was yet to be verified with patient studies. A meta-analysis of 12 studies and 3 guidelines allowed a median limited panel to be defined, a 10 antibody FC panel comprising CD19 (All included studies) ,cCD3 (92% of studies), CD34 and CD10 (83%), cMPO and CD45 (67%), cCD79a and CD13 (58%), CD7 (50%) and HLA-DR (42%). An analysis of FC use as a diagnostic tool in RLS showed that accessibility ranged from 0% to 87% of patients who required it, and that a lack of accessibility had a significant effect on perceived patient outcomes. More studies are required in this area to measure the actual effects of diagnostic limitations, one of which is likely to be under-reporting and under-diagnosis of HM in RLS.

Conclusion – There are limited studies on the use of minimal panel FC for diagnosis of HM in RLS. While there are some region-specific guidelines and panel findings from this review, more studies need to be conducted for assessment and verification of suggested protocols. Ideally, there need to be consensus resource-stratified guidelines supported by evidence for the diagnosis of the most common HM such as acute leukaemia and non-Hodgkin lymphoma.

Item ID:	82994
Item Type:	Conference Item (Presentation)
Related URLs:	https://www.aims.org.au/events/event/qld...
Date Deposited:	20 Jun 2024 01:49
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320102 Haematology @ 50% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3211 Oncology and carcinogenesis > 321106 Haematological tumours @ 50%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200101 Diagnosis of human diseases and conditions @ 100%
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