FLAER‐negative CD15+ neutrophils can be used for the simplified screening of suspected PNH cases. (25th May 2020) - Semchenkova, Alexandra
Abstract: Background: The flow cytometry analysis of GPI‐linked proteins on red blood cells and leukocytes is crucial for paroxysmal nocturnal hemoglobinuria (PNH) diagnostics. However, the commonly used multicolor panels cannot be implemented in low‐resourced hematology laboratories. In order to develop a simple prediagnostic test for PNH screening, we analyzed the diagnostic accuracy of the two‐color (FLAER/CD15) detection of GPI‐deficient neutrophils. Methods: We reanalyzed multicolor data set of 1594 peripheral blood samples of patients screened for PNH applying only two markers (FLAER/CD15). The quantitative positivity/negativity was reported. Then, these results were compared in a blinded manner with previously obtained multicolor data from the same samples. Results: Among the 1594 samples included in the study, 507 samples were PNH‐positive by the multicolor assay. The two‐color method revealed 510 PNH‐positive samples. The detailed examination of this discrepancy revealed 12 false‐positives and 9 false‐negatives. Therefore, FLAER/CD15 screening method displayed 98.90% of the diagnostic specificity and 98.22% of the sensitivity. Conclusion: This simple two‐color evaluation of FLAER‐negative neutrophils is a highly effective screening test for PNH. Although this approach is not intended to replace the multicolor diagnostic procedure, it could minimize the number of patients requiring a conventional multicolor flow cytometric assay.