Peripheral blood and bone marrow immunophenotyping
What flow cytometry measures, when to send peripheral blood rather than marrow, reading a report step by step (lineage, clonality, maturity), the CLL score and its mimics, blast phenotypes, PNH clone testing and MRD, and the traps.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Flow cytometry passes single cells in suspension through lasers. Fluorescent antibodies show which antigens (CD markers) each cell carries, and light scatter gives size and granularity.
- It answers three questions: what lineage (B, T, NK, myeloid, plasma cell), is it clonal, and how mature (blasts versus mature cells).
- Peripheral blood is enough for most lymphocytoses (CLL, MBL, leukaemic lymphoma), circulating blasts and PNH. Marrow is needed for cytopenias without circulating abnormal cells, plasma cell disorders, staging and most MRD.
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Sources
- iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLLHallek M et al., Blood 2018;131:2745-60, 2018
- Chronic lymphocytic leukemia: 2025 update on the epidemiology, pathogenesis, diagnosis, and therapyHallek M, Am J Hematol 2025, 2025
- The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid NeoplasmsAlaggio R et al., Leukemia 2022;36:1720-48, 2022
- ICCS/ESCCA consensus guidelines to detect GPI-deficient cells in paroxysmal nocturnal hemoglobinuria (PNH) and related disorders part 1: clinical utilityDezern AE, Borowitz MJ, Cytometry B Clin Cytom 2018;94:16-22, 2018
- ICCS/ESCCA consensus guidelines to detect GPI-deficient cells in PNH and related disorders part 3: data analysis, reporting and case studiesIllingworth A et al., Cytometry B Clin Cytom 2018;94:49-66, 2018
- RCPA Manual (pathology tests and clinical problems)AU/NZRoyal College of Pathologists of Australasia
- Optimal care pathway for people with chronic lymphocytic leukaemia, 1st editionAU/NZCancer Council Australia
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy