{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T11:15:58Z","timestamp":1778843758901,"version":"3.51.4"},"reference-count":39,"publisher":"Wiley","issue":"22","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008897","name":"Janssen Pharmaceutica","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008897","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Accurate diagnosis of chronic lymphocytic leukemia (CLL) is crucial for effective management. Although recent advancements in flow cytometry have significantly improved diagnostic accuracy, distinguishing atypical cases of CLL remains challenging. This study aimed to identify specific markers to enhance CLL diagnosis and prognostic assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Blood or bone marrow from patients presenting with persistent lymphocytosis (&gt;\u20095\u2009\u00d7\u200910\n                      <jats:sup>3<\/jats:sup>\n                      \/\u03bcL) was collected. Flow cytometric analysis was performed using a customized CLL panel to evaluate the expression of CD markers for the diagnosis of CLL. Clinical and laboratory data were reviewed to support the CLL diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 228 patients were included in the study, including 206 patients (90.4%) in the CLL group and 22 patients (9.6%) in the non\u2010CLL group. The use of CD5, CD19, and CD200 in combination for diagnosing CLL demonstrated a sensitivity of 82.5% (95% CI, 76.6\u201387.4) and a specificity of 90.9% (95% CI, 70.8\u201398.9). In the final predictive model, which incorporated five markers (CD5, CD19, CD200, CD31, and CD11c), both specificity and positive predictive value for CLL diagnosis were close to 100% (95% CI, 84.6\u2013100 and 95.5\u2013100, respectively). CD38 was identified as an independent predictor of increased relapse risk, while LAIR expression was associated with a reduced relapse rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Expression of CD5, CD19, and CD200 by flow cytometry demonstrated a highly sensitive and accurate diagnostic utility for CLL. Adding both CD31 and CD11c to the predictive model further improved diagnostic specificity, reaching as high as 100%. The identification of relapse\u2010associated markers provides valuable insights for personalized treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcla.70116","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T09:52:14Z","timestamp":1759917134000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Optimizing Markers for Chronic Lymphocytic Leukemia Diagnosis by Flow Cytometry: Results From the Nationwide Thai Lymphoma Study Group"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2347-6074","authenticated-orcid":false,"given":"Ornnicha","family":"Sathitakorn","sequence":"first","affiliation":[{"name":"Department of Medicine Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sirorat","family":"Kobbuaklee","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantiya","family":"Chanswangphuwana","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanawat","family":"Rattanathammethee","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine Faculty of Medicine, Chiang Mai University  Chiang Mai Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nisa","family":"Makruasi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine Srinakharinwirot University  Nakhon Nayok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anothai","family":"Chintabanyat","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, Faculty of Medicine Navamindradhiraj University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suporn","family":"Chuncharunee","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Ramathibodi Hospital, Mahidol University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pisa","family":"Phiphitaporn","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Faculty of Medicine, Kon Kaen University  Kon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Archrob","family":"Khuhapinant","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine Faculty of Medicine, Siriraj Hospital, Mahidol University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peerapon","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine Naresuan University  Phitsanulok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakrawadee","family":"Julamanee","sequence":"additional","affiliation":[{"name":"Hematology Unit, Division of Internal Medicine, Faculty of Medicine Prince of Songkla University  Songkhla Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chayapa","family":"Thookhamme","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chulabhorn Hospital Chulabhorn Royal Academy  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lalita","family":"Norasetthada","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine Faculty of Medicine, Chiang Mai University  Chiang Mai Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Udomsak","family":"Bunworasate","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-8681","authenticated-orcid":false,"given":"Kitsada","family":"Wudhikarn","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital  Bangkok Thailand"},{"name":"Center of Excellence in Translational Hematology Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanin","family":"Intragumtornchai","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6949-4449","authenticated-orcid":false,"given":"Chantana","family":"Polprasert","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital  Bangkok Thailand"},{"name":"Center of Excellence in Translational Hematology Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Cancer Stat Facts: Leukemia\u2014Chronic Lymphocytic Leukemia (CLL)","author":"(NIH) NIoH","year":"2020"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15184427"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.584427"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2024.155669"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01620-2"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428199909093723"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1996.d01-1478.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPOGCI3DAXVUMI"},{"issue":"10","key":"e_1_2_10_10_1","first-page":"1640","article-title":"The Immunological Profile of B\u2010Cell Disorders and Proposal of a Scoring System for the Diagnosis of CLL","volume":"8","author":"Matutes E.","year":"1994","journal-title":"Leukemia"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/108.4.378"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.31557\/APJCP.2018.19.12.3383"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2009.01.017"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hon.2510"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2021.1992621"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.21595"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13833"},{"key":"e_1_2_10_18_1","volume-title":"Chronic Lymphocytic Leukaemia\/Small Lymphocytic Lymphoma","author":"Schuh A.","year":"2022"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.b.21890"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365513.2021.1929446"},{"issue":"4","key":"e_1_2_10_21_1","first-page":"374","article-title":"Pathologic Characteristics of Bone Marrow for CD5 Positive Small B Cell Lymphoma","volume":"41","author":"Peng S.","year":"2016","journal-title":"Zhong Nan Da Xue Xue Bao. Yi Xue Ban"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12288-022-01622-1"},{"issue":"10","key":"e_1_2_10_23_1","first-page":"1621","article-title":"Immunophenotyping of Chronic Lymphocytic Leukemia","volume":"63","author":"Falay M.","year":"2017","journal-title":"Clinical Laboratory"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V76.1.123.123"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.4274\/tjh.2017.0085"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2126(96)00076-8"},{"issue":"2","key":"e_1_2_10_27_1","first-page":"178","article-title":"Adhesion Molecules in B\u2010Chronic Lymphoproliferative Disorders","volume":"36","author":"Angelopoulou M. K.","year":"1999","journal-title":"Seminars in Hematology"},{"issue":"1","key":"e_1_2_10_28_1","first-page":"11","article-title":"Pitfalls in Diagnostic Hematopathology: Part I","volume":"2","author":"Zhao X. F.","year":"2009","journal-title":"International Journal of Clinical and Experimental Pathology"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1309\/UQ4N-M5KL-0ANY-YD3G"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10401"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/hon.855"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/110.5.582"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1615\/CritRevImmunol.v35.i5.50"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11264"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1080\/10245330400020470"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232012541"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.096362"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2008.21"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428199609054782"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.3390\/hematolrep15030047"}],"container-title":["Journal of Clinical Laboratory Analysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcla.70116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T04:21:08Z","timestamp":1763958068000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcla.70116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":39,"journal-issue":{"issue":"22","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/jcla.70116"],"URL":"https:\/\/doi.org\/10.1002\/jcla.70116","archive":["Portico"],"relation":{},"ISSN":["0887-8013","1098-2825"],"issn-type":[{"value":"0887-8013","type":"print"},{"value":"1098-2825","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,8]]},"assertion":[{"value":"2025-03-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70116"}}