A Limited Plasma Cell Flow Cytometry Panel With Reflex CD138 Immunohistochemistry Is an Optimal Workflow Process for Evaluating Plasma Cell Neoplasms in Bone Marrow Specimens

Abstract

Assessment of PC clonality using a limited FC panel followed by reflex CD138 immunohistochemistry on cases that are monoclonal by FC provides an optimal and cost-effective workflow for evaluating PCNs in BM samples.

Cost‐effective approach to the diagnostic workup of B cell lymphoproliferative disorders via optimal integration of flow cytometric data

“…Recent studies have proposed that reducing the number of immunomarkers used in the FC analysis of LPDs would help control rising healthcare costs . We agree that optimization of FC panels is valuable; however, we also recognize the advantages of FC immunophenotyping, including fast turnaround time and the ability to assess multiple cell surface and cytoplasmic markers concurrently for a given cell population.…”

“…A recent study examining repeat IHC and FISH testing of breast cancers in core needle biopsy and subsequent excision specimens estimated that such repeat testing cost over $39 000 over a 2‐year period . Furthermore, elimination of duplicate immunophenotyping of plasma cell neoplasms in bone marrow specimens analyzed by FC and IHC was shown to potentially reduce costs by nearly $200 000 over the time period examined . Importantly, the costs generated by duplicate immunophenotyping may not be eligible for reimbursement based on the Medicare National Correct Coding Initiative, which states that ‘Immunohistochemistry…and flow cytometry…should not be reported for the same or similar specimens.…”