Abstract
Objectives
To retrospectively assess the utility of flow cytometry on bone marrow aspirates with respect to the initial diagnosis of myelodysplastic and myeloproliferative neoplasms.
Methods
Flow cytometry results at Brooke Army Medical Center from January 1, 2016, to January 1, 2019, were reviewed on all bone marrow biopsies performed for the initial diagnosis of myelodysplastic (MDS) or myeloproliferative neoplasms (MPN). Results were categorized as normal, abnormal myeloid population, or abnormal lymphoid population.
Results
A total of 197 cases were identified (134 for MDS and 76 for MPN). Of the biopsies for MDS, 27% showed an abnormal myeloid population, and 1% showed an abnormal lymphoid population. Three cases were diagnosed as acute myeloid leukemia. Of the biopsies for MPN, 8% showed an abnormal myeloid population, and 1% showed an abnormal lymphoid population. Cases with incidental abnormal lymphoid populations were small (<5% of events).
Conclusion
In all cases except those diagnosed as acute myeloid leukemia (1.4% of cases), flow cytometry findings did not affect the diagnosis. Based on these findings and the diagnostic criteria in the updated WHO 2016 revision, flow cytometry does not need to be routinely performed on the bone marrow specimens for the diagnosis of MDS or MPN. However, identification of possible cases of acute myeloid leukemia is critical since flow cytometry is required in those cases. Screening of a bone marrow aspirate slide by a pathologist would allow for canceling of unnecessary flow cytometry in these cases and allow for better test utilization.