{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T18:03:57Z","timestamp":1758045837865,"version":"3.44.0"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,6,8]],"date-time":"2025-06-08T00:00:00Z","timestamp":1749340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Monoclonal B\u2010cell lymphocytosis (MBL) is a common cause of lymphocytosis in older individuals. Although cytogenetic\/molecular testing is usually reserved for patients requiring treatment, recent studies suggest that early testing may have a prognostic benefit in MBL and early\u2010stage chronic lymphocytic leukemia (CLL). We evaluated local practices of expanded diagnostics in the MBL\/CLL population to assess (1) adherence to international workshop on CLL (iwCLL) guidelines with respect to additional cytogenetic testing and (2) anticipated costs of expanded diagnostic testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review was conducted on all patients who underwent flow cytometry testing at our center for a suspected hematologic disorder between 2016 and 2021. Patients were subdivided into CLL, high\u2010count MBL, and low\u2010count MBL, and cytogenetic\/molecular testing numbers were calculated as well as associated costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 974 patients who underwent flow cytometry testing, 100 had CLL, 49 had high\u2010count MBL, and 5 had low\u2010count MBL. Cytogenetic testing was performed in 54\/100 CLL, 2\/49 high\u2010count MBL, and 0\/5 low\u2010count MBL patients. Most testing occurred in symptomatic CLL patients (38\/54) especially after the 2018 iwCLL guideline changes. The estimated cost of cytogenetic testing for the 56 patients tested was $27\u2009600. Expanding testing to all patients would have incurred an additional $87\u2009900 during the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This retrospective study shows high adherence to iwCLL guidelines for the investigation of early\u2010stage CLL\/MBL, especially after the 2018 guideline changes. Future studies are needed to weigh the benefits of improved prognostication against resources\/costs required by expanded cytogenetics\/molecular testing in these common hematologic conditions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijlh.14507","type":"journal-article","created":{"date-parts":[[2025,6,8]],"date-time":"2025-06-08T23:19:18Z","timestamp":1749424758000},"page":"891-897","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Single\u2010Center Retrospective Study of the Investigation of Monoclonal B\u2010Cell Lymphocytosis (<scp>MBL<\/scp>) and Chronic Lymphocytic Leukemia (<scp>CLL<\/scp>) in Southwestern Ontario: Are We Over\u2010Investigating?"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0536-4837","authenticated-orcid":false,"given":"Ortenc","family":"Hoxha","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Medicine Schulich School of Medicine and Dentistry, University of Western Ontario  London Ontario Canada"},{"name":"London Health Sciences Centre  London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mrinal","family":"Lad","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Schulich School of Medicine and Dentistry, University of Western Ontario  London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3751-0851","authenticated-orcid":false,"given":"Benjamin D.","family":"Hedley","sequence":"additional","affiliation":[{"name":"London Health Sciences Centre  London Ontario Canada"},{"name":"Department of Pathology and Laboratory Medicine Schulich School of Medicine and Dentistry, University of Western Ontario  London Ontario 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