Limited flow cytometry panels on bone marrow specimens reduce costs and predict negative cytogenetics.

OBJECTIVES To determine the clinical and financial impact and predictive value of a limited flow cytometry strategy in the evaluation of bone marrow specimens. METHODS Consecutive bone marrow cases (n = 1,242) were reviewed following the independent, prospective application of two flow cytometry protocols: a limited marker strategy and a multimarker strategy. Combined morphologic and flow cytometry findings were also compared with cytogenetic results. RESULTS A limited flow cytometry strategy did not have a negative impact on disease detection and resulted in reduced utilization and cost. In addition, negative combined morphology and flow cytometry had a 98.4% predictive value for negative cytogenetics (P < .001). CONCLUSIONS Careful initial evaluation of bone marrow specimens can markedly reduce the costs of bone marrow examination and significantly reduce the need for flow cytometric and cytogenetic studies on these samples.