No abstract

This study confirms the strong association of the MYD88 L265P mutation with LPL, as well as the existence of rare cases of small B-cell lymphoma that complicate this association.

In complex BM cases, the presence of ≥30% CD34+ MKs constitutes a potentially useful diagnostic tool with which to distinguish non-acute myeloid neoplasms and MBA from non-MBA reactive conditions, for minimal additional cost.

FI data derived from 8-color MFC can be used to define marker expression on PCs. Translation of FI data from Infinicyt software to an Excel worksheet streamlines workflow and eliminates transcriptional errors when generating flow reports. © 2018 International Clinical Cytometry Society.

Introduction Chronic myeloid leukemia (CML) usually presents with leukocytosis with neutrophilia, left shift, and basophilia. Documentation of the BCR‐ABL1 fusion is required for diagnosis, and this is often achieved via p210 BCR‐ABL1 real‐time polymerase chain reaction (RT‐PCR). Methods Patients undergoing first‐time testing for p210 BCR‐ABL1 at our institution were retrospectively identified. The medical record was reviewed, and the patient age, sex, clinical indication for testing, and concurrent CBC with differential were identified for 518 patients. BCR‐ABL1 p210 testing had been performed using a laboratory‐developed quantitative RT‐PCR assay. Statistical analysis of the results was performed using an unpaired t test, and P values of <.05 were considered statistically significant. Results Twenty‐four patients received a new diagnosis of CML (4.6%). As compared to patients with a negative PCR, these patients were more likely to have a markedly elevated white blood cell count (WBC), neutrophilia, and a mild anemia. Ninety‐two percent (22/24) of new CML patients had a WBC ≥20 × 109/L, and the two new CML patients with WBC <20 × 109/L had basophilia in the peripheral blood. By contrast, 92% (449/490) of non‐CML patients had a WBC <20 × 109/L. Conclusion The peripheral blood parameters of total WBC ≥20 × 109/L and absolute basophil count can help guide the need for BCR‐ABL1 PCR testing, which can lead to more judicious test utilization, decreased healthcare costs, and decreased false positives, while keeping a high sensitivity for CML. This study also underscores the importance of obtaining a complete differential in patients for whom CML is suspected.