Clinical specimens of blood, bone marrow, lymph node, extranodal tissu
e, and body fluid were collected from 67 cases of hematologic neoplasm
s (including chronic lymphoid leukemias, T- and B-cell lymphomas, and
acute lymphoblastic and myelogenous leukemias) for comparison between
the right-angle light scatter (RALS)/CD45 and the forward-angle light
scatter (FALS)/RALS gating combinations. One to three diagnostic marke
rs were selected from each case, yielding 124 paired results for compa
rison. We found that the percentage of tumor cell isolation and the to
tal cell count in the tumor cell gate were higher in RALS/CD45 than in
FALS/RALS. When 20% was used as a cutoff point, 30 markers in FALS/RA
LS failed to identify the tumor population, while only 3 markers in RA
LS/CD45 failed to do so. The discriminative factor in the RALS/CD45 ga
ting was mainly the CD45 intensity, whereas all cases except 3 showed
low RALS. Although T-cell neoplasms showed a higher proportion of high
CD45 intensity, other groups shared similar ranges of CD45 intensity,
which is therefore of limited value for differential diagnosis. The R
ALS/CD45 combination produces higher recovery and purity for tumor cel
l isolation than the FALS/RALS combination and should replace the latt
er for routine immunophenotyping of lymphoma and leukemia.