{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:55:53Z","timestamp":1789016153473,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T00:00:00Z","timestamp":1640822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cytometry Part B Clinical"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background:<\/jats:bold> It was proposed that peripheral blood (PB) monocyte profiles evaluated by flow cytometry, called \u201cmonocyte assay,\u201d could rapidly and efficiently distinguish chronic myelomonocytic leukemia (CMML) from other causes of monocytosis by highlighting an increase in the classical monocyte (cMo) fraction above 94%. However, the robustness of this assay requires a large multicenter validation and the assessment of its feasibility on bone marrow (BM) samples, as some centers may not have access to PB.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> PB and\/or BM samples from patients displaying monocytosis were assessed with the \u201cmonocyte assay\u201d by 10 ELN iMDS Flow working group centers with harmonized protocols. The corresponding files were reanalyzed in a blind fashion and the cMo percentages obtained by both analyses were compared. Confirmed diagnoses were collected when available.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The comparison between cMo percentages from 267\u2009PB files showed a good global significant correlation (<jats:italic>r<\/jats:italic>\u00a0=\u20090.88) with no bias. Confirmed diagnoses, available for 212 patients, achieved a 94% sensitivity and an 84% specificity. Hence, 95\/101 CMML patients displayed cMo \u226594% while cMo &lt;94% was observed in 83\/99 patients with reactive monocytosis and in 10\/12 patients with myeloproliferative neoplasms (MPN) with monocytosis. The established Receiver Operator Curve again provided a 94% cut\u2010off value of cMo. The 117 BM files reanalysis led to an 87% sensitivity and an 80% specificity, with excellent correlation between the 43 paired samples to PB.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> This ELN multicenter study demonstrates the robustness of the monocyte assay with only limited variability of cMo percentages, validates the 94% cutoff value, confirms its high sensitivity and specificity in PB and finally, also confirms the possibility of its use in BM samples.<\/jats:p>","DOI":"10.1002\/cyto.b.22054","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T12:10:22Z","timestamp":1640866222000},"page":"66-76","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["<scp>ELN iMDS<\/scp> flow working group validation of the monocyte assay for chronic myelomonocytic leukemia diagnosis by flow cytometry"],"prefix":"10.1002","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9071-6683","authenticated-orcid":false,"given":"Orianne","family":"Wagner\u2010Ballon","sequence":"first","affiliation":[{"name":"Department of Hematology and Immunology Assistance Publique\u2010H\u00f4pitaux de Paris, University Hospital Henri Mondor  Cr\u00e9teil France"},{"name":"Inserm U955 IMRB Universit\u00e9 Paris\u2010Est Cr\u00e9teil (UPEC)  Cr\u00e9teil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bettelheim","sequence":"additional","affiliation":[{"name":"Department of Hematology Ordensklinikum Linz Elisabethinen  Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen","family":"Lauf","sequence":"additional","affiliation":[{"name":"Department of Hematology Ordensklinikum Linz Elisabethinen  Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frauke","family":"Bellos","sequence":"additional","affiliation":[{"name":"MLL Munich Leukemia Laboratory  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Della Porta","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital  Milan Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Travaglino","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital  Milan Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9485-0529","authenticated-orcid":false,"given":"Dolores","family":"Subira","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital Universitario de Guadalajara  Guadalajara Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene Nuevo","family":"Lopez","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital Universitario de Guadalajara  Guadalajara Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sihem","family":"Tarfi","sequence":"additional","affiliation":[{"name":"Department of Hematology and Immunology Assistance Publique\u2010H\u00f4pitaux de Paris, University Hospital Henri Mondor  Cr\u00e9teil France"},{"name":"Inserm U955 IMRB Universit\u00e9 Paris\u2010Est Cr\u00e9teil (UPEC)  Cr\u00e9teil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresia M.","family":"Westers","sequence":"additional","affiliation":[{"name":"Department of Hematology Amsterdam UMC, Location VU University Medical Center, Cancer Center Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0743-7400","authenticated-orcid":false,"given":"Ulrika","family":"Johansson","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, SI\u2010HMDS University Hospitals Bristol and Weston NHS Foundation Trust  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherina","family":"Psarra","sequence":"additional","affiliation":[{"name":"Immunology Histocompatibility Dept Evangelismos Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serafeim","family":"Karathanos","sequence":"additional","affiliation":[{"name":"Immunology Histocompatibility Dept Evangelismos Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Matarraz","sequence":"additional","affiliation":[{"name":"Cancer Research Center (IBMCC\u2010USAL\/CSIC), Department of Medicine and Cytometry Service University of Salamanca, Institute for Biomedical Research of Salamanca (IBSAL) and Biomedical Research Networking Centre Consortium of Oncology (CIBERONC)  Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Colado","sequence":"additional","affiliation":[{"name":"Hematology Service and AGC de Laboratorio de Medicina Hospital Universitario Central de Asturias and Instituto Universitario de Oncolog\u00eda del Principado de Asturias  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monali","family":"Gupta","sequence":"additional","affiliation":[{"name":"Immunophenotyping, Department of Haematology and SE\u2010HMDS King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Ireland","sequence":"additional","affiliation":[{"name":"Immunophenotyping, Department of Haematology and SE\u2010HMDS King's College Hospital NHS Foundation 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