Primate Monocytes - CD14, CD16 - Ziegler-Heitbrock

The use of monocyte subset repartitioning by flow cytometry for diagnosis of chronic myelomonocytic leukaemia.

Abstract

Dear Editor, We note with interest Pophali et al.’s1 paper examining the value of monocyte subset repartitioning by multiparametric flow cytometry (MFC) to distinguish chronic myelomonocytic leukaemia (CMML) from other causes of monocytosis. The original paper by Selimoglu-Buet et al.2 in 2015 noted a relative predominance of classical or MO1 monocytes (CD14+/CD16−) at the expense of MO2 (CD14low/CD16+) and MO3 (CD14−/CD16+) monocytes in patients with CMML. These authors suggested that an MO1 percentage cut-off of >94% could predict the diagnosis of CMML with high sensitivity and specificity (both >90%) whereas Pophali et al. were unable to replicate these findings, calling into question the utility of flow cytometry to distinguish the aetiology of monocytosis in a real-world setting. We wish to add data from our own experience to shed further light on this issue.