Low flow: Selecting a limited flow cytometry panel where resources are constrained

Diagnosis and treatment of patients with haematological malignancies (HM) is hampered by access to pathology services in resource-limited settings (RLS). Internationally accepted guidelines and diagnostic criteria for HM require access to sophisticated analysis including comprehensive flow cytometry (FCM) for minimum essential diagnosis and treatment, which is technically challenging in RLS. This review will define these shortcomings and examine the use of limited FCM panels in RLS. While a consensus guideline exists for a limited chronic lymphocytic leukaemia (CLL) FCM panel, this has yet to be validated in a large cohort. Currently, there are no consensus-based and resource-stratified diagnostic protocols defining limited FCM panels for the diagnosis of acute leukaemia where resources are limited. There is an unmet need for such guidelines, supported by evidence, for the diagnosis of the most common HM. This systematic review defines consensus-based limited FCM panels from the literature that may be used in the interim.