{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T12:49:43Z","timestamp":1779281383794,"version":"3.51.4"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T00:00:00Z","timestamp":1632096000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To examine flow cytometric (FCM) findings in clonal cytopenia of undetermined significance (CCUS) in relation to variant allele fraction (VAF) and mutation risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Nine FCM parameters, including 5 FCM metrics (Meyerson-Alayed scoring scheme [MASS] parameters) we previously used to identify myelodysplastic syndromes (MDS), were compared among 96 CCUS samples, 100 low-grade MDS samples and 100 samples from patients without somatic alterations (controls).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>FCM findings did not differ between CCUS samples with less than 20% VAF and controls. CCUS samples with more than 20% VAF (CCUS &amp;gt;20% VAF) demonstrated more than 1 abnormal FCM parameter at a frequency between MDS and controls. Abnormalities in CCUS with high-risk alterations (CCUS(hi)) were similar to MDS, with no statistical difference in the percentage of cases with more than 1 FCM abnormality or a positive MASS score. The positive predictive value (PPV) for clinically significant myeloid processes; MDS, CCUS(hi), and CCUS &amp;gt;20% VAF compared with other CCUS samples and controls was 94.8%, with 96.5% specificity and 61% sensitivity using a modified MASS score. A subset of MDS (43%) was distinguished from CCUS(hi) and CCUS &amp;gt;20% VAF using 3 parameters, with a 93.5% PPV and 83.3% specificity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>FCM abnormalities can distinguish high-risk CCUS based on VAF or alteration type from low-risk CCUS and MDS in many cases. The findings are of potential utility in the evaluation of patients with cytopenias.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqab116","type":"journal-article","created":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T19:21:17Z","timestamp":1622229677000},"page":"219-230","source":"Crossref","is-referenced-by-count":5,"title":["Flow Cytometric Findings in Clonal Cytopenia of Undetermined Significance"],"prefix":"10.1093","volume":"157","author":[{"given":"Priyatharsini","family":"Nirmalanantham","sequence":"first","affiliation":[{"name":"Department of Pathology, University Hospitals of Cleveland and Case Western Reserve University , Cleveland, OH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramen","family":"Sakhi","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals of Cleveland and Case Western Reserve University , Cleveland, OH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rose","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals of Cleveland and Case Western Reserve University , Cleveland, OH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwadwo","family":"Oduro","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals of Cleveland and Case Western Reserve University , Cleveland, OH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramya","family":"Gadde","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals of Cleveland and Case Western Reserve University , Cleveland, OH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Ryder","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals of Cleveland and Case Western Reserve University , Cleveland, OH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3118-4052","authenticated-orcid":false,"given":"Jennifer","family":"Yoest","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals of Cleveland and Case Western Reserve University , Cleveland, OH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5051-717X","authenticated-orcid":false,"given":"Navid","family":"Sadri","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals of Cleveland and Case Western Reserve University , Cleveland, OH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard J","family":"Meyerson","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospitals of Cleveland and Case Western Reserve University , Cleveland, OH , 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