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7 In summary, blasts of AMoL can be. HHS Vulnerability Disclosure, Help Accessed December 2014. If you have a leukemia or lymphoma, routine tests such as a complete blood count (CBC) and a WBC differentialmay show an increased number of white blood cells with a predominance of one type. This test has not been cleared or approved by the US Food and Drug Administration. National Library of Medicine ALL RIGHTS RESERVED. Tel19p/19q used to detect copy number abnormalities of chromosome 19, reveal a hybridization pattern within normal limits in 200 analyzed nuclei. Accessed April 2011. Leukemia & Lymphoma Society [On-line information]. Our results present evidences of an abnormal B-cell maturation in MDS. This case suggested that chromosomal alterations may precede morphological, flow cytometric and clinical changes and accelerate progression of the disease. Grave Encounters What Happened To Kenny, Accessed April 2011. https://www.news-medical.net/health/What-is-Immunophenotyping.aspx. Available online at https://www.mayomedicallaboratories.com/test-catalog/Overview/3287. on this website is designed to support, not to replace the relationship Specific groupings of these antigens are normally present on or within WBCs and are unique to specific cell types and stages of cell maturation. Rosado FG, Morice WG, He R, Howard MT, Timm M, McPhail ED: Immunophenotypic features by multiparameter flow cytometry can help distinguish low grade B-cell lymphomas with plasmacytic differentiation from plasma cell proliferative disorders with an unrelated clonal B-cell process. Frequent CD7 antigen loss in aggressive natural killer-cell leukemia: a useful diagnostic marker. This study examines the immunohistologic profiles of a large series of histologically proven benign and malignant lymphoproliferative processes in order to define immunophenotypic criteria useful in the diagnosis of non-Hodgkin's lymphoma. "What is Immunophenotyping?". Leukemias and lymphomas are caused by an abnormal white blood cell that begins to divide uncontrollably, making numerous copies of itself (clones). The t(14;19)(q32;q13) involving the IGH@ and BCL3 loci is an infrequent cytogenetic abnormality detected in B-cell malignancies. Chronic lymphocytic leukemia is an extremely heterogeneous disease and prognostic factors such as chromosomal abnormalities are important predictors of time to first treatment and survival. Medscape Pediatrics: General Medicine. Correlation assay showed that t(8;21) was only present in 16 AMLM2 patients, and strongly . Aggressive NK Cell Leukemia: Current State of the Art. It is also suggested to have prognostic significance [ 2]. We use cookies to enhance your experience. The synergistic proapoptotic effect of PARP-1 and HDAC inhibition in cutaneous T-cell lymphoma is mediated via Blimp-1. eCollection 2016. Significantly, these morphologic and phenotypic features were seen irrespective of the presence of an overt lymphomatous pattern. The results from your immunophenotyping are compared to the pattern of antigens for normal cells as well as to patterns that are associated with abnormal cells (e.g., cells present with leukemias and lymphomas). Cancers (Basel). No abnormalities were detected for the other phenotypic markers analyzed, including 7.1 ( Table 2 ). In addition to reflexing flow cytometric panels, acute myeloid leukemia (AML) fluorescence in situ hybridization (FISH) testing for PML-RARA translocation t(15;17) may be added by the Mayo Clinic pathologist to exclude acute promyelocytic leukemia if there is morphologic suspicion or if blasts and promyelocytes are CD34-negative and HLA-DR-negative. Would you like email updates of new search results? These antibodies were often linked with a fluorescent or a chemical indicator that would make these abnormal cells visible when observed under a microscope. 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Search by expertise, name or affiliation. (2012 February 17). No immunophenotypic myeloid abnormalities were detected in the healthy donor bone marrow aspirates or in the 10 remission bone marrow aspirates from patients with a history of nonmyeloid neoplasia (Table 3). Having a predilection for the right side of the heart and accounting for 1% of all cardiac tumours, the difficulty in diagnosing the lesion, owing to the location and vague presenting symptoms and signs, often leads to delayed diagnosis and poor prognosis. Overall, del(13q14) and +12 were the most common abnormalities (39%), whereas del(11q13), del(17p13), and del(6q23) were detected only in 3, 1, and 0 cases, respectively. For solid tissue specimens, order LLPT / Leukemia/Lymphoma Immunophenotyping, Flow Cytometry, Tissue. News-Medical. American Cancer Society [On-line information]. Available online at https://emedicine.medscape.com/article/207631-overview. Clinical features, laboratory findings, morphologic, cytogenetic features, and Epstein-Barr virus status were important factors for diagnosing aggressive NK cell leukemia. In general, these criteria involved identification of abnormal expression or loss of antigens in B- and T-lineage populations. These may be the first indication of a possible blood cell cancer. Cytometry B Clin Cytom. Information about the potential relationship between genetic abnormalities and immunophenotypic markers is currently limited to the association found between t(11;14 . Am J Med. 1985 Oct;66(4):848-58 The results may also be used to predict how aggressive the cancer will be and/or whether it will respond to certain treatment. Application of these criteria to a series of nearly 500 cases of lymphoma indicated that over 90% of B-lineage and about 80% of T-lineage neoplasms manifested immunophenotypic abnormalities that could distinguish them from benign, reactive lymphoid processes. Available online at https://www.cancer.org/cancer/leukemia-in-children/detection-diagnosis-staging/how-diagnosed.html. It can detect normal cells as well as abnormal cells whose pattern of markers are typically seen with specific types of leukemia and lymphoma. Immunophenotyping detects the presence or absence of antigens found on the surface or interior of blood cells. Two atypical human non-Hodgkin's lymphomas (NHLs) that exhibited unusual genotypic and in situ immunophenotypic abnormalities are described. (Reviewed 2010 December). It can detect normal cells as well as abnormal cells whose pattern of markers are typically seen with specific types of leukemia and lymphoma. Evaluating lymphocytoses of undetermined etiology, Identifying B- and T-cell lymphoproliferative disorders involving blood and bone marrow Distinguishing acute lymphoblastic leukemia (ALL) from acute myeloid leukemia (AML) Immunologic subtyping of ALL Distinguishing reactive lymphocytes and lymphoid hyperplasia from malignant lymphoma Distinguishing between malignant lymphoma and acute leukemia Phenotypic subclassification of B- and T-cell chronic lymphoproliferative disorders, including chronic lymphocytic leukemia, mantle cell lymphoma, and hairy cell leukemia Recognizing AML with minimal morphologic or cytochemical evidence of differentiation Recognizing monoclonal plasma cells, Identifying B- and T-cell lymphoproliferative disorders involving blood and bone marrow, Distinguishing acute lymphoblastic leukemia (ALL) from acute myeloid leukemia (AML) Immunologic subtyping of ALL Distinguishing reactive lymphocytes and lymphoid hyperplasia from malignant lymphoma Distinguishing between malignant lymphoma and acute leukemia Phenotypic subclassification of B- and T-cell chronic lymphoproliferative disorders, including chronic lymphocytic leukemia, mantle cell lymphoma, and hairy cell leukemia Recognizing AML with minimal morphologic or cytochemical evidence of differentiation Recognizing monoclonal plasma cells, Distinguishing acute lymphoblastic leukemia (ALL) from acute myeloid leukemia (AML), Immunologic subtyping of ALL Distinguishing reactive lymphocytes and lymphoid hyperplasia from malignant lymphoma Distinguishing between malignant lymphoma and acute leukemia Phenotypic subclassification of B- and T-cell chronic lymphoproliferative disorders, including chronic lymphocytic leukemia, mantle cell lymphoma, and hairy cell leukemia Recognizing AML with minimal morphologic or cytochemical evidence of differentiation Recognizing monoclonal plasma cells, Distinguishing reactive lymphocytes and lymphoid hyperplasia from malignant lymphoma Distinguishing between malignant lymphoma and acute leukemia Phenotypic subclassification of B- and T-cell chronic lymphoproliferative disorders, including chronic lymphocytic leukemia, mantle cell lymphoma, and hairy cell leukemia Recognizing AML with minimal morphologic or cytochemical evidence of differentiation Recognizing monoclonal plasma cells, Distinguishing reactive lymphocytes and lymphoid hyperplasia from malignant lymphoma, Distinguishing between malignant lymphoma and acute leukemia Phenotypic subclassification of B- and T-cell chronic lymphoproliferative disorders, including chronic lymphocytic leukemia, mantle cell lymphoma, and hairy cell leukemia Recognizing AML with minimal morphologic or cytochemical evidence of differentiation Recognizing monoclonal plasma cells, Distinguishing between malignant lymphoma and acute leukemia, Phenotypic subclassification of B- and T-cell chronic lymphoproliferative disorders, including chronic lymphocytic leukemia, mantle cell lymphoma, and hairy cell leukemia Recognizing AML with minimal morphologic or cytochemical evidence of differentiation Recognizing monoclonal plasma cells, Phenotypic subclassification of B- and T-cell chronic lymphoproliferative disorders, including chronic lymphocytic leukemia, mantle cell lymphoma, and hairy cell leukemia, Recognizing AML with minimal morphologic or cytochemical evidence of differentiation Recognizing monoclonal plasma cells, Recognizing AML with minimal morphologic or cytochemical evidence of differentiation. An ASCUS pap smear result is considered to be mildly abnormal. Morice WG, Kimlinger T, Katzmann JA, et al: Flow cytometric assessment of TCR-Vbeta expression in the evaluation of peripheral blood involvement by T-cell lymphoproliferative disorders: a comparison with conventional T-cell immunophenotyping and molecular genetic techniques. I got thre results today, which were "no significant abnormalities". Available online at https://www.questdiagnostics.com/hcp/intguide/jsp/showintguidepage.jsp?fn=TG_Lymphoid_Neoplasms.htm. -Confirmatory cytochemical stains as needed. . Currently, the diagnosis of ANKL remains challenging. FOIA It may be used in follow up to a complete blood count (CBC) and WBC differential that show an increased number of lymphocytes or the presence of immature blood cells or other abnormal cell counts. No flow cytometric abnormalities were detected in CD4-positive T-cells from 10 control patients without lymphoproliferative disorders. Torpy, J. This process is widely used to diagnose different types of lymphoma and leukemia by comparing normal cells and cancer cells. No significant associations were detected between the presence of flow cytometric abnormalities (defined as 2 or more abnormalities) in RCC patients and age or sex, the presence of human leukocyte antigen (HLA)-DR15 (found in an increased frequency in adult low-grade MDS and aplastic anemia patients 33 32 and associated with a better response to In her spare time, she loves to cook up a storm in the kitchen with her super-messy baking experiments. Pagana, K. D. & Pagana, T. J. 1993 Mar;9(4-5):285-91. doi: 10.3109/10428199309148525. doi: 10.1371/journal.pone.0158827. Please note that medical information found government site. Lymphoid Neoplasms Laboratory Support of Diagnosis and Management Test Guide. Federal government websites often end in .gov or .mil. 4th ed. Before Submission of bilateral specimens is not required. As the number of abnormal cells increases in the bone marrow, they may crowd out and inhibit the production of normal white blood cells, red blood cells, and platelets, and eventually abnormal cells may also be released into the blood. Treatment of plasma cell neoplasms (including multiple myeloma, monoclonal gammopathy of undetermined significance, and plasmacytoma) includes observation, chemotherapy, radiation therapy, stem cell rescue, targeted therapy, immunotherapy, and supportive therapies. while also discussing the various products Sartorius produces in order to aid in this. 122 cases were also subjected to karyotype analysis by Gbanding technology and abnormal karyotypes were detected in 69 out of 122 patients. B-cell leukemia/lymphoma panel. Susha has a Bachelor of Science (B.Sc.) Abnormal patterns of expression for at least one antigen was found in 91% of RA/RARS cases and in 74% of RAEB. An additional complicating factor is antigenic shift, 13 , 20 although the number of cases in which immunophenotypically aberrant blasts convert to an . Immunophenotyping hematopoietic specimens can help resolve many differential diagnostic problems posed by the clinical or morphologic features. Additionally, specific patterns of antigens are present on abnormal cells seen in leukemias and lymphomas. 2022 Aug 12;13:970183. doi: 10.3389/fimmu.2022.970183. al. National Cancer Institute [On-line information]. Available online at https://www.mayoclinic.com/health/chronic-lymphocytic-leukemia/DS00565. CD34 cells can be detected in cord blood, bone marrow and in the peripheral blood of normal subjects, where they constitute respectively about 1.5% and 0.1-0.01% of the elements . Immunophenotyping is a test used to identify cells on the basis of the types of markers or antigens present on the cells surface, nucleus, or cytoplasm. This technique helps in prognostication and is also used to differentiate between neoplastic and reactive expansions of lymphocytes. Medeiros BC, Kohrt HE, Arber DA, Bangs CD, Cherry AM, Majeti R, Kogel KE, Azar CA, Patel S, Alizadeh AA. Flow Cytometric Immunophenotyping Is Sensitive for the Early Diagnosis of De Novo Aggressive Natural Killer Cell Leukemia (ANKL): A Multicenter Retrospective Analysis. The .gov means its official. Although diagnosticcriteria are well established, a No immunophenotypicmyeloid abnormalitieswere detectedin the healthy donor bone marrow aspirates or in the 10 remission bone marrow aspirates from patients with a history of nonmyeloid neoplasia Table 3, As mentioned, the immunophenotypicpanels used evolved during the study, and not all antigens Accessed January 2020. al. Phenotypic analysis by flow cytometry of surface immunoglobulin light chains and B and T cell antigens in lymph nodes involved with non-Hodgkin's lymphoma. CD38 expression is not detected (<10%) No evidence of p53 (17p13) 4. In fact, these two markers are not normally expressed together. However, treatment with chemotherapy may eliminate the abnormal cells, and if treatment is successful, normal white blood cells (WBCs) will replace abnormal cells. 1985 Aug 29;313(9):534-8 Chronic lymphocytic leukemia is an extremely heterogeneous disease and prognostic factors such as chromosomal abnormalities are important predictors of time to first treatment and survival. 2020 Jan;98(1):99-107. doi: 10.1002/cyto.b.21782. 1998 Feb;109(2):211-20. doi: 10.1093/ajcp/109.2.211. These abnormalities were related to immunophenotypic markers as This study prospectively analysed the relationships between immunophenotypic and cytogenetic features of blast cells in 432 acute non-lymphoblastic leukemias (ANLL) at presentation. Accessed April 2011. (2009 January 28). 2021 Jun 7;22(7):60. doi: 10.1007/s11864-021-00857-w. J Oral Maxillofac Pathol. Specimen Stability Information: Refrigerated < or =96 hours. Available online at https://www.arupconsult.com/Topics/LymphomaPhenotyping.html. If no abnormalities are detected by the initial panel, no further flow cytometric assessment will be performed unless otherwise indicated by specific features of the clinical presentation or prior laboratory results. Leukemia & Lymphoma Society. Both mature and immature B cells are normally positive for the CD19 marker. Percentage of abnormal cells :91% B-cells, small size cells. It is not offered in every laboratory, but many larger hospitals and academic medical centers perform the testing or your sample may be sent to a reference laboratory. Trisomy 12 is the second most frequent aberration detected by fluorescence in situ hybridization at the time of diagnosis (10-25%), and it confers an . Leukemia Acute Lymphocytic (Adults). As the number of abnormal cells increase in a lymph node, the size of the lymph node increases. If possible, fluids other than spinal fluid should be anticoagulated with heparin (1 U/mL of fluid). Acute Lymphoblastic Leukemia (ALL). In this case report of a child with mosaic T21 and DS-AMKL, flow cytometry performed on BMA showed no immunophenotypic abnormalities, morphological review of BMA revealed no clusters of tumor cells, and BMA failed to show the expected GATA1 mutation. 2022 Apr;71(4):919-932. doi: 10.1007/s00262-021-03051-x. MeSH Flow cytometry immunophenotyping is used primarily to help diagnose and classify blood cell cancers (leukemias and lymphomas) and to help guide their treatment. Large granular lymphocytic leukemia: a brief review. Immunophenotyping, a common application in flow cytometry, allows multiple cell surface markers to be simultaneously characterized on a per-cell basis.Immunophenotyping can be difficult by flow cytometry, however, when only a small number of cells are available. If cell count is less than 10 cells/mcL, a larger volume of spinal fluid may be required. al. Flow Cytometry: Principles and Clinical Applications in Hematology Clinical Chemistry 46:8(B) 12211229 [On-line information]. Available online at https://www.cancer.org/cancer/acute-lymphocytic-leukemia/detection-diagnosis-staging/how-diagnosed.html. The prognostic value of immunophenotyping in AML is controversial [ 3]. Atypical or abnormal cells can demonstrate . Korean J Lab Med. Prieto F, Bada L, Palau F, Beneyto M, Montero MR, Martnez-Castellano F. Asthana A, Ramakrishnan P, Vicioso Y, Zhang K, Parameswaran R. Mol Cancer Ther. (2019 January 3, Updated). 2018 Jun 1;128(6):2519-2534. doi: 10.1172/JCI97053. Or it can be the result of a specific treatment. A comparison of MBL with overt chronic lymphoproliferations revealed common aspects in the preclinical state, regarding both the kind of cytogenetic aberrations detected and . Rereview of PB smears from these patients, who had typical cutaneous findings of MF, did not identify definitive Sezary cells. News-Medical. MeSH terms Chromosome Aberrations Before Report will include a morphologic description, a summary of the procedure, the percent positivity of selected antigens, and an interpretive conclusion based on the correlation of the clinical history with the morphologic features and immunophenotypic results. Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2954680/. For assistance, contact. Blood Journal v111 (8) [On-line information]. Disclaimer. An abnormal karyotype was detected in 232 cases (54%). Several studies have identified a relationship between AML prognosis and antigens such as CD7, CD9, CD11b, CD13, CD14, CD15, CD33, CD34, and CD56, though some other studies report conflicting results. Immunophenotyping is widely used for the following reasons: Two types of tests are used in immunophenotyping: The choice of test is based on the type of sample: Heres a brief overview of the two types of test methods: In flow cytometry, the sample may range from blood, fluids in the body cavity (such as peritoneal or pleural fluids), bone marrow, or solid tissues in liquid media. In univariate analysis, CD9, CD10, CD15, CD34 and TdT expression appeared significantly associated with chromosomal anomalies. CD56 (26.0%) and CD7 (20.8%) were the most commonly expressed lymphoid markers in AML patients. Second, unusual expression of surface antigens in ANKL cells was a prominent feature. Diagnosis of malignant lymphoma - An overview. (Updated 2014 March 23). Available online at https://www.mayomedicallaboratories.com/test-catalog/Overview/3287. . In these cases, LSC analysis is a methodology of choice because of its low sample requirements. June 10, 2022 heart medicine dandelions and roundup. Accessed January 2020. Specimens will be initially triaged to determine which, if any, of the immunophenotyping panels should be performed. the immunophenotyping panels should be performed. -, Blood. government site. (2018 March 12). It depends. with these terms and conditions. In case 14, a patient had PCM with del(13q/RB1) as a sole abnormality detected by FISH and this patient's disease remained active during the following 17 months. Sometimes pieces of the abnormal myeloma protein are filtered through the kidney into the urine. These abnormalities were related to immunophenotypic markers as detected using a consensual panel of monoclonal antibodies allowing lineage assignment and investigation of myeloid marker expression on blast cells. Additional FISH or molecular testing may be recommended by the Mayo pathologist to facilitate diagnosis. Clinical Laboratory Medicine. If no abnormalities are detected by the initial panel, no further flow cytometric assessment will be performed unless otherwise indicated by specific features of the clinical presentation or prior laboratory results. low reading R03.1 . Chen, Y. (2019 January, Updated).Acute Lymphoblastic Leukemia ALL. National Library of Medicine Fonatsch C, Gudat H, Lengfelder E, Wandt H, Silling-Engelhardt G, Ludwig WD, Thiel E, Freund M, Bodenstein H, Schwieder G, et al. Send whole blood specimen in original tube. PMC Flow cytometric immunophenotyping evaluates individual cells in suspension for the presence and absence of specific antigens (phenotype). Immunophenotypically, both NHLs lacked surface Ig heavy chains. Maturation-associated immunophenotypic abnormalities in bone marrow Background: Atypical lymphocytosis is a common peripheral blood abnormality seen not only in Epstein-Barr virus (EBV)-associated acute infectious mononucleosis but also in other conditions, including other viral infections, cancer, immune . Accessed December 2014. Because of the heterogeneity and commonly associated cytogenetic abnormalities AML-MRC has no specific immunophenotypic profile. Blood Tests. Jevremovic D, Dronca RS, Morice WG, et al: CD5+ B-cell lymphoproliferative disorders: Beyond chronic lymphocytic leukemia and mantle cell lymphoma. D20S108 (20q12), used to detect deletion/copy number abnormalities of chromosome 20, reveals an abnormal hybridization pattern consistent with deletion 20q12 in 12 of 200 analyzed nuclei. If additional testing is required, it will be added per the algorithm to fully characterize a disease state with a charge per unique antibody tested. The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical. In this article, News-Medical talks to Sartorius about biosensing and bioprocessing in gene therapy, Owned and operated by AZoNetwork, 2000-2023. 04 March 2023. Atypical cells can change back to normal cells if the underlying cause is removed or resolved. Shi M, Jevremovic D, Otteson GE, Timm MM, Olteanu H, Horna P: Single antibody detection of T-cell receptor alpha beta clonality by flow cytometry rapidly identifies mature T-cell neoplasms and monotypic small CD8-positive subsets of uncertain significance. eCollection 2019. Epub 2021 Sep 14. As mentioned, the immunophenotypic panels used evolved during the study, and not all antigens were studied in the entire MDS patient group . In this example, abnormal CD34-positive blasts show uniform expression of CD56 and partial expression of CD7. MedlinePlus Medical Encyclopedia [On-line information]. The granulocytes (67% of the total white blood cells) and monocytes (5% of the total white blood cells) reveal no significant immunophenotypic abnormalities. For bone marrow testing, if cytogenetic tests are desired along with this test request, an additional specimen should be submitted. Flow cytometry immunophenotyping may be ordered when you have an increased number of lymphocytes (or sometimes an increase in another type of white blood cell, WBC), anemia, a decreased platelet count, or immature WBCs that are not normally seen in the blood. In our case report, a middle-aged male . Understanding Laboratory Tests. Accessed January 2020. 3. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). However, lymphoma cells may or may not find their way to the bloodstream and might require other collection techniques. Liendo C, Danieu L, Al-Katib A, Koziner B. In these cases, LSC analysis is a methodology of choice because of its low sample requirements. If the CT scan said that there are no significant abnormalities it means that nothing out of the ordinary was noted. It may be because the markers of interest are not available for flow cytometryor because fresh cells or tissue are not available (a requirement for flow cytometry immunophenotyping). (accessed March 04, 2023). More importantly, there are newer classes of treatment options like CAR-T therapy, bispecific T-cell engagers, and monoclonal antibodies thatselectively target molecules like CD19 or CD20. Flow cytometric immunophenotyping is an established method for the detection of occult leptomeningeal disease in patients with aggressive B-cell non-Hodgkin lymphoma, and is increasingly being used in the evaluation of patients without an established diagnosis of lymphoma who present with signs and/or symptoms referable to the central nervous Smaller volumes can be used if there is a high cell count. Available online at https://emedicine.medscape.com/article/990113-overview. Nat Rev Immunol v12 (3): 191200. or negative if no abnormal population was detected. How Is Childhood Leukemia Diagnosed? Unauthorized use of these marks is strictly prohibited. Each persons condition will be unique. 19952023 Mayo Foundation for Medical Education and Research. Leuk Res. This site needs JavaScript to work properly. Blood Adv. Sometimes, a tissue sample, such as from a lymph node, is obtained using a biopsy or fine needle aspiration (FNA) procedure. and transmitted securely. Blood. Immunophenotyping is widely used for the following reasons: To differentiate between: Acute myeloid and lymphoid leukemia B and T cell lymphoid neoplasms such as chronic lymphocytic leukemia and. In: McClatchey KD, ed. Available online at https://www.cancer.gov/cancertopics/factsheet/detection/laboratory-tests. In addition, reflex testing may occur to fully characterize a disease state or clarify any abnormalities from the screening test. Accessed April 2011. First, the CD45/linear side scatter gating of flow cytometry allows the initial identification of neoplastic subpopulations for additional immunophenotypic analysis in half of ANKL cases. Flow cytometric immunophenotyping of peripheral blood, bone marrow, and body fluids is performed using the following antibodies: Triage Panel: CD3, CD10, CD16, CD19, CD34, CD45 and kappa and lambda light chains, -B-cell Panel: CD5, CD11c, CD19, CD20, CD22, CD23, CD38, CD45, CD103, CD200 and kappa and lambda light chains, -T-cell Panel: CD2, CD3, CD4, CD5, CD7, CD8, CD45, TRBC1, and gamma/delta, -Killer-cell immunoglobulin-like receptor (KIR) Panel: CD3, CD8, CD16, CD56, CD57, CD94, CD158a, CD158b, CD158e (p70), and NKG2a, -Acute Panel: CD2, CD7, CD13, CD15, CD16, CD33, CD34, CD36, CD38, CD45, CD56, CD64, CD117, and HLA-DR, -B-cell ALL, minimal residual disease (MRD) panel: CD10, CD19, CD20, CD22, CD24, CD34, CD38, CD45, CD58, and CD66c, -Myeloperoxidase (MPO)/terminal deoxynucleotidyl transferase (TdT) (MPO/TdT) Panel: cytoplasmic CD3, CD13, cytoplasmic CD22, CD34, CD45, cytoplasmic CD79a, nuclear TdT, and cytoplasmic MPO, -Plasma Cell Panel: CD19, CD38, CD45, CD138, and cytoplasmic kappa and lambda light chains, -Mast Cell Panel: CD2, CD25, CD69, CD117. Submit only 1 of the following specimens: Preferred: Yellow top (ACD solution A or B), Acceptable: Green top (sodium heparin) or lavender top (EDTA), Slides: If possible, include 5 to 10 unstained blood smears labeled with two unique identifiers.