{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T17:28:17Z","timestamp":1779902897497,"version":"3.53.1"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T00:00:00Z","timestamp":1645747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cytometry Part B Clinical"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Multicolor flow cytometry\u2010based DNA\u2010ploidy (MFC\u2010ploidy) analysis is a simple, sensitive, and popular method for ploidy analysis in B\u2010cell acute lymphoblastic leukemia (B\u2010ALL). However, the utility of MFC\u2010ploidy in the detection of B\u2010ALL with endoreduplication or masked hypodiploidy has not been reported. Herein, we studied the patterns of MFC\u2010ploidy assessment and its utility to detect B\u2010ALL with hypodiploidy and endoreduplication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MFC\u2010ploidy analysis was performed using FxCycle Violet\u2010dye\u2010based method, and cytogenetic ploidy was evaluated using chromosomal\u2010counting and FISH analysis. A total of 20 B\u2010ALL cases with endoreduplication were studied for the patterns of MFC\u2010ploidy analysis and compared with 250 patients with hyperdiploidy and 11 cases with pure hypodiploidy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All B\u2010ALL with endoreduplication revealed two distinct peaks (populations) on MFC\u2010ploidy analysis: the first (hypodiploid) peak (median\u2014DNA\u2010index [DI], 0.82; range, 0.6\u20130.95) and the second (hyperdiploid) peak with almost twice DI (median\u2013DI, 1.53; range, 1.14\u20131.75). Cytogenetic findings were available in 19 cases and confirmed hypodiploidy with endoreduplication in 13\/19 (68.4%) and only hypodiploidy in 3\/19 cases. The remaining three cases showed hyperdiploid blasts in cytogenetic studies. Of these three, two cases had &lt;10% blasts population with hypodiploidy. Thus, masked\u2010hypodiploidy could be diagnosed correctly in 3\/19 cases on MFC\u2010ploidy analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MFC\u2010ploidy analysis shows a characteristic pattern of DNA\u2010ploidy in samples with endoreduplication. It allows the distinction between samples with masked hypodiploidy from true hyperdiploidy. An integrated approach involving cytogenetic and MFC\u2010ploidy detection is very helpful in the risk stratification of B\u2010ALL in routine clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cyto.b.22063","type":"journal-article","created":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T09:40:50Z","timestamp":1645782050000},"page":"199-208","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Detecting hypodiploidy with endoreduplication and masked hypodiploidy in B\u2010cell acute lymphoblastic leukemia using multicolor flow cytometry"],"prefix":"10.1002","volume":"102","author":[{"given":"Anumeha","family":"Chaturvedi","sequence":"first","affiliation":[{"name":"Hematopathology Laboratory, ACTREC, Tata Memorial Center Homi Bhabha National Institute (HBNI) University  Navi Mumbai Maharashtra 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Anil","family":"Gujarathi","sequence":"additional","affiliation":[{"name":"Hematopathology Laboratory, ACTREC, Tata Memorial Center Homi Bhabha National Institute (HBNI) University  Navi Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sweta","family":"Rajpal","sequence":"additional","affiliation":[{"name":"Hematopathology Laboratory, ACTREC, Tata Memorial Center Homi Bhabha National Institute (HBNI) University  Navi Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Patkar","sequence":"additional","affiliation":[{"name":"Hematopathology Laboratory, ACTREC, Tata Memorial Center Homi Bhabha National Institute (HBNI) University  Navi Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prathibha","family":"Amare\u2010Kadam","sequence":"additional","affiliation":[{"name":"Cancer Cytogenetics Department, ACTREC, Tata Memorial Center HBNI University  Navi 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