Flow Cytometric, Morphologic, and Laboratory Comparative Study in Patients With Leukocytosis and Cytopenia

Area of Science:

• Hematology
• Clinical Pathology

Background:

• Flow cytometry immunophenotyping (FCI) and peripheral blood smear (PBS) morphology are diagnostic tools in hematology.
• Evaluating the utility of FCI as a primary screening method for hematologic conditions is crucial.

Purpose of the Study:

• To assess the effectiveness of FCI as a screening test for patients presenting with leukocytosis and cytopenia.
• To compare the diagnostic yield of FCI with PBS morphology in this patient cohort.

Main Methods:

• A retrospective analysis of 320 patients was conducted between August 2016 and December 2016.
• Both FCI and PBS morphology were evaluated for all identified patients.
• Patient indications for FCI, including history of hematologic malignancy (HHM), leukocytosis, and cytopenia, were recorded.

Main Results:

• The positive FCI rate was low (4.4%–12.5%) in patients with absolute neutrophilia, especially when circulating blasts were excluded.
• Patients with absolute lymphocytosis demonstrated a high positive FCI rate (93%).
• Patients with HHM and pancytopenia had a higher incidence of positive FCI findings compared to those without HHM and with isolated cytopenia. PBS morphology showed a strong correlation with FCI (P = .0001).

Conclusions:

• Peripheral blood smear evaluation is an accurate and cost-effective screening test for hematologic abnormalities.
• Flow cytometry immunophenotyping has a very low diagnostic yield for patients with mature neutrophilia and isolated cytopenia.