Flow cytometry vs manual count

[Barb]

Hello. Anyone know why there might be such descrepencies in the manual blast count vs the cd 34 blast count by flow cytometry? My peripheral blood blast counts done by manual smear have been 6% and 10% (different pathologists). The flow cytometry shows 1% blasts.

Beyond that, all my counts are dropping, except my basos and monos are high. All this after 12 years stability with a MDS 5q- diagnosis. I had a BMB yesterday, results next week.

[Hopeful]

Hi Barb,

It is my understanding that because flow cytometry is automated, they can quickly analyze 1000's of cells. However, with manual counts, they may only analyze 100's of cells.

As to why the numbers are so far off, I can only speculate. Perhaps the manual count is high because they were counting all blast cells, whereas the flow cytometry may have only been specifically looking for those with CD34?? Or perhaps the flow cytometry machine was not calibrated correctly??? I am just guessing here. Please let us know what you learn

Have you started or will you be starting Revlimid?

Hope your BMB results are stable!

[Barb]

Hi Hopeful. I am not on Revlimid because I have been so stable. I figured the day would come when it was time for it. Maybe the hemo will start it

I do know there can be other ways of measuring blasts. I do not fully understand them. The flow cytometry on the BMB aspirate came back. It reports 1% CD34+ blasts. On the same line it also says: approximately 81% of granulocytes with decreased side light scatter. In the interpretation it says "no increase in CD34+ blasts." Are grans with decreased side light scatter blasts? I do belive decreased side scatter shows immaturity of the grans.

It's so hard waiting for Thursday.

[Hopeful]

Originally Posted by Barb

I do know there can be other ways of measuring blasts. I do not fully understand them. The flow cytometry on the BMB aspirate came back. It reports 1% CD34+ blasts. On the same line it also says: approximately 81% of granulocytes with decreased side light scatter. In the interpretation it says "no increase in CD34+ blasts." Are grans with decreased side light scatter blasts? I do belive decreased side scatter shows immaturity of the grans.

It's so hard waiting for Thursday.

Hi Barb,

Sorry that I can't help you interpret that part of the flow cytometry report! No increase in CD34+ blasts sounds good though

Revlimid is the miracle-drug for MDS with del 5q. Make sure that your doctor is consulting with someone with expertise in the treatment of MDS.

Good luck Thursday!

[Barb]

I just read the reports from my BMB. Diagnosis is AML with 5q-, trisomy 8, and MLL genes. I meet with the hemo tomorrow to discuss treatment. That's all I can say right now, it is still sinking in.

[Hopeful]

Oh Barb! I am so sorry to read this! It was the last thing that I expected to hear.
I hope it goes okay tomorrow.

[Barb]

The hemo i have been seeing is transferring me to The James Cancer Center at Ohio State U. I go tomorrow. I am hoping I can put chemo off until Monday. I am doing ok. My emotions have been all over the place. I decided what else can one do when diagnosed with AML, but to call a friend, drink some wine and eat Chinese. So that is just what I did.

[Cheryl C]

Very sorry to read this, Barb. You must be in shock after 12 years of stability. Wishing you all the best as you pursue treatment. I'll be watching for your posts.