{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T09:41:00Z","timestamp":1697017260386},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,3,8]],"date-time":"2013-03-08T00:00:00Z","timestamp":1362700800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cytometry Part B Clinical"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background:<\/jats:title><jats:p>Laboratories utilize diverse methods to determine the absolute count used to distinguish chronic lymphocytic leukemia (CLL) from monoclonal B lymphocytosis, with many using dual platform (DP) methods (flow cytometric percent of CLL\u2010like B cells \u00d7 hematology analyzer white blood cell count). However, flow cytometric tube\u2010to\u2010tube variation may make interpretation difficult, particularly when the CLL\u2010like B\u2010cell count straddles the recommended threshold. This study investigates the extent, and potential sources, of this variability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Flow cytometric enumeration was performed on 20 samples with CLL\u2010like B cells and 10 control specimens using single platform (SP) and two DP tubes A: kappa, lambda, CD5, CD10, CD19, CD38, CD45, CD20 and B: FMC\u20107, CD23, CD19, CD5, with and without racking to remove doublets. In addition, reproducibility studies were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Three specimens showed discordant CLL\u2010like B\u2010cell counts relative to the threshold of 5 \u00d7 10<jats:sup>9<\/jats:sup>\/L. Bland\u2013Altman analysis demonstrated a systematic bias with DP Tube B &gt; A (5.9%) and SP &gt; DP Tube A (9.5%). The doublet percent varied between specimens, but did not account for the bias between DP tubes. Variation was also seen in enumeration of other cell types, suggesting multiple potential sources of inconsistency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Significant tube\u2010to\u2010tube variation may be seen in CLL\u2010like B\u2010cell counts. The precise cause of these differences is uncertain, but is likely multifactorial. If the clinical utility of an absolute threshold for the diagnosis of CLL can be confirmed, it will be important to establish recommendations for standardization, similar to those employed for CD4 and CD34 enumeration. \u00a9 2013 International Clinical Cytometry Society<\/jats:p><\/jats:sec>","DOI":"10.1002\/cyto.b.21077","type":"journal-article","created":{"date-parts":[[2013,3,8]],"date-time":"2013-03-08T13:48:07Z","timestamp":1362750487000},"page":"149-156","source":"Crossref","is-referenced-by-count":2,"title":["Monoclonal B lymphocytosis versus chronic lymphocytic leukemia: Factors affecting implementation of an absolute threshold"],"prefix":"10.1002","volume":"84B","author":[{"given":"Marian A.","family":"Rollins\u2010Raval","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona E.","family":"Craig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,3,8]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-06-093906"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-09-176149"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2010.030189"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.20556"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-05-158444"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.5858\/2006-130-680-CACFCI"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/0471722731"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.1171"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.21023"},{"key":"e_1_2_6_11_2","series-title":"Clinical Flow Cytometric Analysis of Neoplastic Hematolymphoid Cells; Approved Guideline\u2014Second Edition","first-page":"h43","author":"Stetler\u2010Stevenson M","year":"2007"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)91807-K"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.20093"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.10084"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.20370"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.20500"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2257.1999.00236.x"},{"key":"e_1_2_6_18_2","first-page":"1031","article-title":"Comparison of three single platform methods for CD34+ hematopoietic stem cell enumeration by flow cytometry","volume":"57","author":"Marinov I","year":"2011","journal-title":"Clin Lab"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.20351"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.20604"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.10032"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1100532"}],"container-title":["Cytometry Part B: Clinical Cytometry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcyto.b.21077","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cyto.b.21077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T16:34:02Z","timestamp":1696955642000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cyto.b.21077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3,8]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,5]]}},"alternative-id":["10.1002\/cyto.b.21077"],"URL":"https:\/\/doi.org\/10.1002\/cyto.b.21077","archive":["Portico"],"relation":{},"ISSN":["1552-4949","1552-4957"],"issn-type":[{"value":"1552-4949","type":"print"},{"value":"1552-4957","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3,8]]}}}