An Update on Flow Cytometry Analysis of Hematological Malignancies: Focus on Standardization

Flow cytometry use has significantly increased in clinical laboratories and has significantly helped improve the diagnosis of leukemias, lymphomas, and follow-up of minimal residual disease. Mastering this technique enables the performance of multiparametric single-cell analysis and increases the odds of identifying abnormal populations. As in many fields, there is a need to improve the quality of the data generated for accuracy, reproducibility, and trueness. The implementation of solutions reducing variability is achievable and needed, as the flow cytometry workflow involves many manual steps and items susceptible to operator bias and human error. Standardization of flow cytometry assays is sought and already implemented in many clinical hematology laboratories. However, the clinical community would highly benefit from further efforts in that direction to increase the comparability of findings across laboratories. This review covers the strengths and weaknesses of flow cytometry and focuses on the standardization approaches developed, including recent advances in the field.