Cell Count Differentials by Cytomorphology and Next-Generation Flow Cytometry in Bone Marrow Aspirate: An Evidence-Based Approach
Metadata
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MDPI
Materia
Bone marrow aspirate Cytomorphology Next generation flow Differential cell counts 200 vs 500 cutoffs; ISO15189 Preanalytical quality Multiple myeloma Plasma cells Blasts Diagnostic efficiency Clinical laboratory Clinical significance
Date
2023-03-11Referencia bibliográfica
Ríos-Tamayo, R.; Sánchez, M.J.; Gómez-Rojas, S.; Rodríguez-Barranco, M.; Segura, G.P.; Redondo-Sánchez, D.; CARREÑO-TARRAGONA, G.; Nicolás, A.R.; Ruiz-Cabello, F.; Jiménez, P.; et al. Cell Count Differentials by Cytomorphology and Next-Generation Flow Cytometry in Bone Marrow Aspirate: An Evidence-Based Approach. Diagnostics 2023, 13, 1071. [https:// doi.org/10.3390/ diagnostics13061071]
Abstract
Despite a lack of evidence, a bone marrow aspirate differential of 500 cells is commonly
used in the clinical setting. We aimed to test the performance of 200-cell counts for daily hematological
workup. In total, 660 consecutive samples were analyzed recording differentials at 200 and 500 cells.
Additionally, immunophenotype results and preanalytical issues were also evaluated. Clinical and
statistical differences between both cutoffs and both methods were checked. An independent control
group of 122 patients was included. All comparisons between both cutoffs and both methods for
all relevant types of cells did not show statistically significant differences. No significant diagnostic
discrepancies were demonstrated in the contingency table analysis. This is a real-life study, and
some limitations may be pointed out, such as a different sample sizes according to the type of cell in
the immunophenotype analysis, the lack of standardization of some preanalytical events, and the
relatively small sample size of the control group. The comparisons of differentials by morphology on
200 and 500 cells, as well as by morphology (both cutoffs) and by immunophenotype, are equivalent
from the clinical and statistical point of view. The preanalytical issues play a critical role in the
assessment of bone marrow aspirate samples.