{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T12:37:19Z","timestamp":1792931839746,"version":"4.5.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"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":[[2026,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Flow cytometry is a crucial diagnostic tool in hematopathology. It supports the identification and follow-up of hematolymphoid neoplasms by providing detailed immunophenotypic data and quantification, and is applicable to various specimen types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Content<\/jats:title>\n                    <jats:p>Classification and management of acute myeloid leukemia (AML), the most common type of acute leukemia in adults, are complex and evolving, guided by International Consensus Classification and World Health Organization 5th edition diagnostic frameworks, as well as the clinically oriented European LeukemiaNet recommendations. These systems stratify AML based on genomic, morphologic, and immunophenotypic features, informing treatment and outcomes. While cytogenetic and molecular data are central to subclassification, flow cytometry remains essential for rapid diagnostic and prognostic insights. This review explores the role of flow cytometry in diagnosing AML, monitoring disease progression, and assessing measurable residual disease, a key relapse and\/or outcome predictor. It details how flow cytometry establishes cell lineage, identifies immunophenotypic markers, and predicts genetic alterations in certain subtypes of AML. Examples of analysis strategies and common flow cytometry patterns, as well as references to in-depth recent review articles on the biology, diagnosis and management of AML in the broader context of myeloid malignancies are provided.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Flow cytometry is indispensable in the diagnosis, classification, and monitoring of AML. Its ability to provide precise, quantitative information enables early and accurate diagnosis, optimizes treatment, and enhances posttherapy monitoring. Although sophisticated flow cytometry-based approaches may be limited to specialized laboratories, laboratory medicine professionals benefit from a thorough understanding of this technology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/clinchem\/hvaf111","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:49:42Z","timestamp":1756381782000},"page":"238-253","source":"Crossref","is-referenced-by-count":5,"title":["Flow Cytometry in Acute Myeloid Leukemia (AML): A Critical Tool for Accurate Diagnosis, Classification, and Monitoring"],"prefix":"10.1093","volume":"72","author":[{"given":"Fabienne","family":"Lucas","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Washington , Seattle, WA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sindhu","family":"Cherian","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Washington , Seattle, WA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A","family":"Linden","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota , Minneapolis, MN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrnoosh","family":"Tashakori","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota , Minneapolis, MN ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"2026020307470961900_hvaf111-B1","volume-title":"Haematolymphoid tumours [WHO classification of tumours series]","author":"WHO Classification of Tumours Editorial Board","year":"2024","edition":"5th Ed."},{"key":"2026020307470961900_hvaf111-B2","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1182\/blood.2022015850","article-title":"International Consensus Classification of Myeloid Neoplasms and Acute Leukemias: integrating morphologic, clinical, and genomic data","volume":"140","author":"Arber","year":"2022","journal-title":"Blood"},{"key":"2026020307470961900_hvaf111-B3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s00428-022-03430-4","article-title":"The International Consensus Classification of acute myeloid leukemia","volume":"482","author":"Weinberg","year":"2023","journal-title":"Virchows Arch Int J Pathol"},{"key":"2026020307470961900_hvaf111-B4","volume-title":"The international consensus classification of myeloid and lymphoid neoplasms","author":"Arber","year":"2025","edition":"1st Ed"},{"key":"2026020307470961900_hvaf111-B5","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1182\/blood.2022016867","article-title":"Diagnosis and management of AML in adults: 2022 recommendations from an international expert panel on behalf of the ELN","volume":"140","author":"D\u00f6hner","year":"2022","journal-title":"Blood"},{"key":"2026020307470961900_hvaf111-B6","doi-asserted-by":"crossref","first-page":"101518","DOI":"10.1016\/j.beha.2023.101518","article-title":"WHO, what, when, where, and why: new classification systems for acute myeloid leukemia and their impact on clinical practice","volume":"36","author":"Appelbaum","year":"2023","journal-title":"Best Pract Res Clin Haematol"},{"key":"2026020307470961900_hvaf111-B7","doi-asserted-by":"crossref","first-page":"104358","DOI":"10.1016\/j.critrevonc.2024.104358","article-title":"A practical algorithm for acute myeloid leukaemia diagnosis following the updated 2022 classifications","volume":"198","author":"Della Porta","year":"2024","journal-title":"Crit Rev Oncol Hematol"},{"key":"2026020307470961900_hvaf111-B8","author":"Chang"},{"key":"2026020307470961900_hvaf111-B9","first-page":"2813","article-title":"How I treat AML incorporating the updated classifications and guidelines","volume":"141","author":"El Chaer","year":"2023","journal-title":"Blood"},{"key":"2026020307470961900_hvaf111-B10"},{"key":"2026020307470961900_hvaf111-B11","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1002\/cyto.b.22108","article-title":"Multiparameter flow cytometry in the evaluation of myelodysplasia: analytical issues: recommendations from the European LeukemiaNet\/International Myelodysplastic Syndrome Flow Cytometry Working Group","volume":"104","author":"Porwit","year":"2023","journal-title":"Cytometry B Clin Cytom"},{"key":"2026020307470961900_hvaf111-B12","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1002\/cyto.b.22046","article-title":"Flow cytometric analysis of myelodysplasia: pre-analytical and technical issues-recommendations from the European LeukemiaNet","volume":"104","author":"van der Velden","year":"2023","journal-title":"Cytometry B Clin Cytom"},{"key":"2026020307470961900_hvaf111-B13","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/cyto.b.22044","article-title":"Clinical application of flow cytometry in patients with unexplained cytopenia and suspected myelodysplastic syndrome: a report of the European LeukemiaNet International MDS-Flow Cytometry Working Group","volume":"104","author":"van de Loosdrecht","year":"2023","journal-title":"Cytometry B Clin Cytom"},{"key":"2026020307470961900_hvaf111-B14","doi-asserted-by":"crossref","first-page":"2753","DOI":"10.1182\/blood.2021013626","article-title":"2021 update on MRD in acute myeloid leukemia: a consensus document from the European LeukemiaNet MRD working party","volume":"138","author":"Heuser","year":"2021","journal-title":"Blood"},{"key":"2026020307470961900_hvaf111-B15","doi-asserted-by":"crossref","first-page":"e676","DOI":"10.1097\/HS9.0000000000000676","article-title":"Technical aspects of flow cytometry-based measurable residual disease quantification in acute myeloid leukemia: experience of the European LeukemiaNet MRD working party","volume":"6","author":"Tettero","year":"2022","journal-title":"HemaSphere"},{"key":"2026020307470961900_hvaf111-B16","author":"Shapiro"},{"key":"2026020307470961900_hvaf111-B17","volume-title":"Flow cytometry in evaluation of hematopoietic neoplasms: a case-based approach","author":"Cherian","year":"2012"},{"key":"2026020307470961900_hvaf111-B18","volume-title":"Color atlas of flow cytometry","author":"Karlon","year":"2023"},{"key":"2026020307470961900_hvaf111-B19","doi-asserted-by":"crossref","first-page":"aqae187","DOI":"10.1093\/ajcp\/aqae187","article-title":"Flow cytometry evaluation of acute myeloid leukemia minimal residual disease based on an understanding of the normal maturation patterns in the blast compartments","volume":"163","author":"Roshal","year":"2025","journal-title":"Am J Clin Pathol"},{"key":"2026020307470961900_hvaf111-B20","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.cll.2023.04.005","article-title":"Advances in acute myeloid leukemia classification, prognostication and monitoring by flow cytometry","volume":"43","author":"Lucas","year":"2023","journal-title":"Clin Lab Med"},{"key":"2026020307470961900_hvaf111-B21","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1007\/s00292-023-01272-8","article-title":"The role of flow cytometry in the classification of myeloid disorders","volume":"44","author":"Saft","year":"2023","journal-title":"Pathol Heidelb Ger"},{"key":"2026020307470961900_hvaf111-B22","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1038\/s41375-021-01498-6","article-title":"Blasts\u201d in myeloid neoplasms\u2014how do we define blasts and how do we incorporate them into diagnostic schema moving forward?","volume":"36","author":"Chen","year":"2022","journal-title":"Leukemia"},{"key":"2026020307470961900_hvaf111-B23","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.cll.2017.07.003","article-title":"Acute myeloid leukemia immunophenotyping by flow cytometric analysis","volume":"37","author":"Chen","year":"2017","journal-title":"Clin Lab Med"},{"key":"2026020307470961900_hvaf111-B24","first-page":"1003","article-title":"Sensitive detection and enumeration of CD34+ cells in peripheral and cord blood by flow cytometry","volume":"22","author":"Sutherland","year":"1994","journal-title":"Exp Hematol"},{"key":"2026020307470961900_hvaf111-B25","author":"Wood"},{"key":"2026020307470961900_hvaf111-B26","volume-title":"Multiparameter flow cytometry in the diagnosis of hematologic malignancies","author":"Porwit","year":"2025","edition":"2nd Ed"},{"key":"2026020307470961900_hvaf111-B27","doi-asserted-by":"crossref","first-page":"3855","DOI":"10.3390\/cancers16223855","article-title":"Acute myeloid leukemia: diagnosis and evaluation by flow cytometry","volume":"16","author":"Ally","year":"2024","journal-title":"Cancers (Basel)"},{"key":"2026020307470961900_hvaf111-B28","author":"Platzbecker"},{"key":"2026020307470961900_hvaf111-B29","doi-asserted-by":"crossref","first-page":"4192","DOI":"10.3390\/cancers16244192","article-title":"Acute promyelocytic leukemia-like AML: genetic perspective and clinical implications","volume":"16","author":"Guarnera","year":"2024","journal-title":"Cancers (Basel)"},{"key":"2026020307470961900_hvaf111-B30","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1038\/s41408-021-00561-w","article-title":"Characteristics and outcome of acute myeloid leukemia with uncommon retinoic acid receptor-alpha (RARA) fusion variants","volume":"11","author":"Cicconi","year":"2021","journal-title":"Blood Cancer J"},{"key":"2026020307470961900_hvaf111-B31","first-page":"69","article-title":"Relapsed acute promyelocytic leukemia lacks \u201cclassic\u201d leukemic promyelocyte morphology and can create diagnostic challenges","volume":"147","author":"Dayton","year":"2017","journal-title":"Am J Clin Pathol"},{"key":"2026020307470961900_hvaf111-B32","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s00277-012-1580-5","article-title":"KIT D816 mutation associates with adverse outcomes in core binding factor acute myeloid leukemia, especially in the subgroup with RUNX1\/RUNX1T1 rearrangement","volume":"92","author":"Kim","year":"2013","journal-title":"Ann Hematol"},{"key":"2026020307470961900_hvaf111-B33","doi-asserted-by":"crossref","first-page":"336","DOI":"10.3390\/cancers13020336","article-title":"Prognostic impacts of D816V KIT mutation and peri-transplant RUNX1-RUNX1T1 MRD monitoring on acute myeloid leukemia with RUNX1-RUNX1T1","volume":"13","author":"Cho","year":"2021","journal-title":"Cancers (Basel)"},{"key":"2026020307470961900_hvaf111-B34","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1182\/bloodadvances.2019000709","article-title":"Prospective evaluation of prognostic impact of KIT mutations on acute myeloid leukemia with RUNX1-RUNX1T1 and CBFB-MYH11","volume":"4","author":"Ishikawa","year":"2020","journal-title":"Blood Adv"},{"key":"2026020307470961900_hvaf111-B35","doi-asserted-by":"crossref","first-page":"7399","DOI":"10.1158\/0008-5472.CAN-04-1865","article-title":"PAX5 expression in acute leukemias: higher B-lineage specificity than CD79a and selective association with t(8;21)-acute myelogenous leukemia","volume":"64","author":"Tiacci","year":"2004","journal-title":"Cancer Res"},{"key":"2026020307470961900_hvaf111-B36","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1093\/ajcp\/aqae060","article-title":"Integrative immunophenotypic and genetic characterization of acute myeloid leukemia with CBFB rearrangement","volume":"162","author":"Sameeta","year":"2024","journal-title":"Am J Clin Pathol"},{"key":"2026020307470961900_hvaf111-B37","doi-asserted-by":"crossref","first-page":"3322","DOI":"10.1182\/bloodadvances.2019000328","article-title":"Blast phenotype and comutations in acute myeloid leukemia with mutated NPM1 influence disease biology and outcome","volume":"3","author":"Mason","year":"2019","journal-title":"Blood Adv"},{"key":"2026020307470961900_hvaf111-B38","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1002\/cyto.b.22095","article-title":"Flow cytometry immunophenotypic features of pure erythroid leukemia and the distinction from reactive erythroid precursors","volume":"102","author":"Fang","year":"2022","journal-title":"Cytometry B Clin Cytom"},{"key":"2026020307470961900_hvaf111-B39","first-page":"2275","article-title":"The international consensus classification of acute leukemias of ambiguous lineage","volume":"141","author":"Weinberg","year":"2023","journal-title":"Blood"},{"key":"2026020307470961900_hvaf111-B40","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1002\/cyto.b.21783","article-title":"Multiparameter flow cytometry applications in the diagnosis of mixed phenotype acute leukemia","volume":"96","author":"Porwit","year":"2019","journal-title":"Cytometry B Clin Cytom"},{"key":"2026020307470961900_hvaf111-B41","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1111\/bjh.18632","article-title":"Plasmacytoid dendritic cells in the setting of myeloid neoplasms: diagnostic guide to challenging pathologic presentations","volume":"200","author":"El Hussein","year":"2023","journal-title":"Br J Haematol"},{"key":"2026020307470961900_hvaf111-B42","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.3390\/cancers16112118","article-title":"Flow cytometry profiling of plasmacytoid dendritic cell neoplasms","volume":"16","author":"El Hussein","year":"2024","journal-title":"Cancers (Basel)"},{"key":"2026020307470961900_hvaf111-B43","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1182\/blood.2020007897","article-title":"Plasmacytoid dendritic cell expansion defines a distinct subset of RUNX1-mutated acute myeloid leukemia","volume":"137","author":"Xiao","year":"2021","journal-title":"Blood"},{"key":"2026020307470961900_hvaf111-B44","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s11912-024-01503-y","article-title":"Novel therapeutic targets in Acute Myeloid Leukemia (AML)","volume":"26","author":"Wysota","year":"2024","journal-title":"Curr Oncol Rep"},{"key":"2026020307470961900_hvaf111-B45","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1038\/s41408-024-01143-2","article-title":"Current status and research directions in acute myeloid leukemia","volume":"14","author":"Kantarjian","year":"2024","journal-title":"Blood Cancer J"},{"key":"2026020307470961900_hvaf111-B46","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.blre.2018.10.003","article-title":"Prognostic and therapeutic role of CLEC12A in acute myeloid leukemia","volume":"34","author":"Morsink","year":"2019","journal-title":"Blood Rev"},{"key":"2026020307470961900_hvaf111-B47","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.path.2023.01.006","article-title":"Diagnostic flow cytometry in the era of targeted therapies: lessons from therapeutic monoclonal antibodies and chimeric antigen receptor T-cell adoptive immunotherapy","volume":"16","author":"Obiorah","year":"2023","journal-title":"Surg Pathol Clin"},{"key":"2026020307470961900_hvaf111-B48","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1002\/cyto.b.21854","article-title":"Common flow cytometry pitfalls in diagnostic hematopathology","volume":"96","author":"Cherian","year":"2019","journal-title":"Cytometry B Clin Cytom"},{"key":"2026020307470961900_hvaf111-B49","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.5858\/arpa.2014-0543-CP","article-title":"Marked variability in reported minimal residual disease lower level of detection of 4 hematolymphoid neoplasms: a survey of participants in the College of American Pathologists Flow Cytometry Proficiency Testing Program","volume":"139","author":"Keeney","year":"2015","journal-title":"Arch Pathol Lab Med"},{"key":"2026020307470961900_hvaf111-B50","volume-title":"CLSI H62: validation of assays performed by flow cytometry","author":"CLSI","year":"2021","edition":"1st Ed"}],"container-title":["Clinical Chemistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/clinchem\/advance-article-pdf\/doi\/10.1093\/clinchem\/hvaf111\/64883011\/hvaf111.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/clinchem\/advance-article-pdf\/doi\/10.1093\/clinchem\/hvaf111\/64883011\/hvaf111.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T12:47:24Z","timestamp":1770122844000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/clinchem\/article\/72\/2\/238\/8300284"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":50,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,10,23]]},"published-print":{"date-parts":[[2026,2,3]]}},"URL":"https:\/\/doi.org\/10.1093\/clinchem\/hvaf111","relation":{},"ISSN":["0009-9147","1530-8561"],"issn-type":[{"value":"0009-9147","type":"print"},{"value":"1530-8561","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2025,10,23]]}}}