基于价值的慢性淋巴细胞增殖性疾病流量检测：一个旨在开发简化检测和降低成本算法的质量改进项目。
Value-based flow testing of chronic lymphoproliferative disorders: a quality improvement project to develop an algorithm to streamline testing and reduce costs.
机构信息
From the Department of Pathology and Laboratory Medicine, Children's Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles;
Department of Pathology, University of Texas Medical Branch, Galveston;
出版信息
Am J Clin Pathol. 2014 Sep;142(3):411-8. doi: 10.1309/AJCP0SWZJ6GBDHPF.
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.
目的
流式细胞术对于评估淋巴增殖性疾病（LPD）及其分类至关重要。流式细胞术检测通常包含大量抗体，这使得检测既复杂又昂贵；对于良性病例或诊断明确的病例，这种面板可能没有必要。我们的目的是通过对血液中可能发生的 LPD 的流式细胞术研究进行回顾性分析，制定一种更具成本效益的检测策略。
方法
我们确定了 LPD 的频率和类型，以及与患者年龄和绝对淋巴细胞计数相关的结果。
结果
我们发现 LPD 的可能性随着患者年龄和绝对淋巴细胞计数的增加而增加，并且在我们的机构中，CD5 阳性 LPD 是最常见的 LPD（71%的 LPD）。利用这些数据，我们设计了流式细胞术检测算法，对疾病风险低的患者进行筛查，并重点检测 CD5 阳性 LPD，必要时进行反射检测。
结论
我们预计这种方法将导致抗体利用率降低 40%。
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