Objectives: Flow cytometry is essential for the evaluation of lymphoproliferative disorders (LPDs) and their classification. Flow panels routinely incorporate a large array of antibodies, making testing complex and expensive; such panels are likely unnecessary in benign cases or those with straightforward diagnoses. Our aim was to develop a more cost-effective testing strategy based on a retrospective analysis of flow studies for possible LPDs in blood.
Methods: We identified LPD frequencies and types, as well as associated results with patient age and absolute lymphocyte count.
Results: We found that the likelihood of LPDs increased with patient age and absolute lymphocyte count and that CD5-positive LPD was the most common LPD diagnosed in our institution (71% of LPDs). Using these data, we devised flow-testing algorithms with a screening test for patients at low risk of disease and a focus on CD5-positive LPD detection, with reflexing as needed.
Conclusions: We project this approach will result in a 40% decrease in antibody utilization.
Keywords: Absolute lymphocyte count; Flow cytometry; Lymphoproliferative disorder; Quality improvement; Receiver operating characteristic curve.
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