{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T15:13:16Z","timestamp":1781795596851,"version":"3.54.5"},"reference-count":34,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T00:00:00Z","timestamp":1743811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Based on CD14\/CD16 expression, monocytes can be divided into the following three functionally distinct subsets: classical (MO1, CD14++\/CD16-), intermediate (MO2, CD14+\/CD16+) and non-classical (MO3, CD14dim\/CD16-). An expanded MO1 subset (cutoff, \u226594%) was found to be predictive of CMML. However, the utility of this test in routine practice has important limitations, with some reporting low sensitivity or a lack of correlation. Here, we sought to evaluate the practical usefulness of this test by using our routine antibody panel and a new gating strategy. Methods: Our study included 56 peripheral blood (PB) and 69 bone marrow (BM) samples. The PB cohort included 20 patients with CMML, 21 with no myeloid neoplasms (non-MN) and 15 with other myeloid neoplasms (non-CMML-MN). The BM cohort included 25 CMML, 16 non-MN and 28 non-CMML-MN cases. Taking advantage of an existing 8-color myelomonocytic tube routinely used in our lab, we conducted a retrospective monocyte subset analysis using a new sequential gating strategy. Results: The assay was able to distinguish CMML from non-CMML cases with high sensitivity (90.0%) and specificity (88.9%) in blood samples using a cutoff value of MO1 &gt; 94%. For BM samples, a reduced MO3 &lt; 1.24% was more closely associated with CMML with a sensitivity of 96.0% and a specificity of 79.5%. A side-by-side comparison of our assay with the original \u201cmonocyte assay\u201d showed strong agreement. Conclusions: Our study demonstrates the utility of a practical and robust approach for monocyte subset analysis in the diagnosis of CMML.<\/jats:p>","DOI":"10.3390\/cancers17071229","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T03:23:07Z","timestamp":1743996187000},"page":"1229","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Usefulness of Flow Cytometry Monocyte Partitioning in the Diagnosis of Chronic Myelomonocytic Leukemia in a Real-World Setting"],"prefix":"10.3390","volume":"17","author":[{"given":"Yijie","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Pathology, Northwestern University Feinberg School of Medicine & Northwestern Memorial Hospital, Chicago, IL 60611, USA"},{"name":"Clinical Flow Cytometry Laboratory, Department of Pathology, Northwestern Memorial Hospital, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Tariq","sequence":"additional","affiliation":[{"name":"Department of Pathology, Northwestern University Feinberg School of Medicine & Northwestern Memorial Hospital, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5216-3889","authenticated-orcid":false,"given":"Lucy","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Northwestern University Feinberg School of Medicine & Northwestern Memorial Hospital, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juehua","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Pathology, Northwestern University Feinberg School of Medicine & Northwestern Memorial Hospital, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taruna","family":"Jagtiani","sequence":"additional","affiliation":[{"name":"Clinical Flow Cytometry Laboratory, Department of Pathology, Northwestern Memorial Hospital, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristy","family":"Wolniak","sequence":"additional","affiliation":[{"name":"Department of Pathology, Northwestern University Feinberg School of Medicine & Northwestern Memorial Hospital, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barina","family":"Aqil","sequence":"additional","affiliation":[{"name":"Department of Pathology, Northwestern University Feinberg School of Medicine & Northwestern Memorial Hospital, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8849-3625","authenticated-orcid":false,"given":"Peng","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Pathology, Northwestern University Feinberg School of Medicine & Northwestern Memorial Hospital, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Hua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Northwestern University Feinberg School of Medicine & Northwestern Memorial Hospital, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing Ching","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Northwestern University Feinberg School of Medicine & Northwestern Memorial Hospital, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1182\/blood-2016-03-643544","article-title":"The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia","volume":"127","author":"Arber","year":"2016","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3932","DOI":"10.1182\/blood-2010-10-311019","article-title":"Mutational spectrum analysis of chronic myelomonocytic leukemia includes genes associated with epigenetic regulation: UTX, EZH2, and DNMT3A","volume":"118","author":"Jankowska","year":"2011","journal-title":"Blood"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2186","DOI":"10.1182\/blood-2012-06-440347","article-title":"Clonal architecture of chronic myelomonocytic leukemias","volume":"121","author":"Itzykson","year":"2013","journal-title":"Blood"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"10767","DOI":"10.1038\/ncomms10767","article-title":"Mutation allele burden remains unchanged in chronic myelomonocytic leukaemia responding to hypomethylating agents","volume":"7","author":"Merlevede","year":"2016","journal-title":"Nat. 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