Central nervous system (CNS) involvement is a serious but often underdiagnosed complication of hematological malignancies. Currently, the gold standard to detect CNS involvement is conventional cytology (CC) whose sensitivity though is lower than 50%. Multiparametric flow cytometry (MFC) demonstrated a superior sensitivity over CC, particularly when low levels of CNS infiltrating cells are present. Although prospective studies are few, a positive finding by MFC appears to anticipate an adverse outcome even if CC shows no infiltration. However, the use of MFC to diagnose CNS involvement presents some pitfalls, due to the typical hypocellularity of cerebrospinal fluids (CSF), and low cell vitality. Furthermore, the threshold to be used for defining the MFC positivity is not universally defined. In this paper, a working group of the European Society for Clinical Cell Analysis—ESCCA—and the Italian Society for Clinical Cell Analysis—ISCCA—will discuss the critical aspects of CSF processing, highlighting difficulties in storage and processing of samples, interpretation and reporting of data.

中文翻译：

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ESCCA/ISCCA 协议通过多参数流式细胞术分析血液系统恶性肿瘤的脑脊液

中枢神经系统 (CNS) 受累是血液系统恶性肿瘤的一种严重但经常被漏诊的并发症。目前，检测中枢神经系统受累的金标准是常规细胞学（CC），其灵敏度虽然低于 50%。多参数流式细胞术 (MFC) 显示出优于 CC 的灵敏度，特别是当存在低水平的 CNS 浸润细胞时。尽管前瞻性研究很少，但即使 CC 没有显示浸润，MFC 的积极发现似乎也预示着不良结果。然而，由于脑脊液 (CSF) 的典型低细胞性和低细胞活力，使用 MFC 诊断 CNS 受累存在一些缺陷。此外，用于定义 MFC 积极性的阈值没有被普遍定义。在本文中，