Flow cytometric immunophenotyping of hematological malignancies: the way forward in Nigeria

Abstract

Aim: This review serves to awaken the interest of stakeholders involved in research and management of hematological malignancies (HM) in the efficacy of flow cytometry in the immunophenotypic characterization of leukemias and lymphomas. This well-defined characterization plays a crucial role in diagnosis, classification, prognostic evaluation, and detection of minimal residual disease, in the context of clinical features and morphological diagnosis. Methodology: Relevant literature was retrieved to highlight the principles of operation of flow cytometry, indications and applications, derivable clinical information and clinical relevance, sources of error, and necessary steps towards definitive and specific diagnosis of each HM. Conclusion: Flow cytometric immunophenotyping (FCIMPT) of HM is highly demanding and capital intensive but its usefulness in profiling these exceptionally heterogeneous disorders, and allowing proper classification along the latest WHO classification guidelines, thereby paving the way for targeted therapy and clinical trial-driven management, significantly outweighs the cost, which can be fully recovered if properly managed. In a low-resource setting like Nigeria, limited immunohistochemistry serves to bridge the gap in technological advancement.