Pre-analytical factors affecting cytogenetic cell culture yield in haematological malignancies

Abstract

OBJECTIVES:        To determine the association between different factors and the yield of cytogenetic culture in-terms of failure in samples drawn from patients suffering from haematological diseases.

 STUDY DESIGN:   Descriptive cross-sectional study.

SETTING/DURATION OF STUDY:         Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi, Dec 2021 to Sep 2022.

 METHODOLOGY:  We conducted this study on 226 peripheral blood and bone aspirate samples received for cytogenetic culture. Samples from patients aged between 5 and 70 years, of both genders, suffering from a primary haematological disease were included. Frozen samples, or those with a quantity less than 1 mL were excluded. Patients were documented for demographic data, disease and sample characteristics. All samples were cultured and assessed for success of culture. Data was analyzed using SPSS 26.0.

RESULTS:    The sample had a median age of 34.5 (7 - 64) years, of whom 123 (54.4%) were male. Samples with culture failure had significantly lower volumes of receipt with a mean value of 2.10 ± 0.98 mL versus 3.52 ± 0.99 mL in cultures that were successful, (p<0.001). Samples that were partially clotted also had a higher incidence of cell culture failure, (p<0.001), with only 8.8% of samples showing clotting in those that were successful versus  26.9% that had cell culture failure. Additionally, cell culture had a higher chance of yielding a successful result if it was received for processing within twenty-four hours of withdrawal, with the success rate decreasing with the passage of time especially past the seventy-two-hour window, (p<0.001).

CONCLUSION:       Delayed sample dispatch, clotted samples and inadequate volume are important factors associated with the failure of cell culture for cytogenetics.

KEYWORDS:          Cytogenetic Culture Failure, Haematological Diseases.