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However, despite the development of algorithms and guidelines, there is still a lack of standardization of the FC assessment of bone marrow dysplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>By combining FC, together with morphological analysis and cytogenetic\/molecular assessment in a training cohort of 209 patients, we created a novel score, ProGraME, which includes four parameters, each from a different cell lineage (Progenitor cells, Granulocytes, Monocytes, Erythroid precursors), solely based on relevant population gating. Points for ProGraME were attained for: lymphoid precursors \u22645% of all CD34+ cells (1.5 point); a granulocyte\u2010to\u2010lymphocyte side\u2010scatter ratio \u22646 (1 point); a monocyte CD33\u2010CV%\u2009\u2265\u200963 (2 points), and an erythroid precursor CD36\u2010CV%\u2009\u2265\u200965 (2 points).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using a cutoff of \u22652 as suggestive of dysplasia, ProGraME showed a sensitivity of 91% and a specificity of 81% in the training cohort and 95% and 75%, respectively, in an independent validation cohort of 159 patients. In addition, ProGraME had a very high negative predictive value of 97.1% and 97.8% in the training and validation cohorts, respectively, offering a useful tool for excluding bone marrow dysplasia. Finally, among the 23 CCUS patients that scored positive for dysplasia with ProGraME in the training cohort, 16 of them (69%) carried high\u2010risk mutations, suggesting that FC might help identify early changes of dysplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ProGraME can potentially optimize the FC diagnosis of low\u2010risk myelodysplasia without minimal requirements of flow analysis other than accurate population gating.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.14086","type":"journal-article","created":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T23:45:00Z","timestamp":1692834300000},"page":"851-862","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["<scp>ProGraME<\/scp>: A novel flow cytometry algorithm for the diagnosis of low\u2010risk myelodysplastic syndromes in patients with cytopenia"],"prefix":"10.1111","volume":"111","author":[{"given":"Jesper","family":"Therkelsen","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Hematology Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dicte Wilhjelm","family":"Tr\u00e6den","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Hematology Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ida","family":"Schj\u00f8dt","sequence":"additional","affiliation":[{"name":"Department of Hematology Rigshospitalet  Copenhagen Denmark"},{"name":"Flow Cytometry Laboratory Rigshospitalet  Copenhagen 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