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Guidelines for the diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria and related disorders by flow cytometry

Open access
Borowitz, Michael J., Craig, Fiona E., DiGiuseppe, Joseph A., Illingworth, Andrea J., Rosse, Wendell, Sutherland, D. Robert, Wittwer, Carl T., Richards, Stephen J.·2010·Cytometry Part B: Clinical Cytometry

Abstract

Background: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare hematopoietic stem cell disorder characterized by a somatic mutation in the PIGA gene, leading to a deficiency of proteins linked to the cell membrane via glycophosphatidylinositol (GPI) anchors. While flow cytometry is the method of choice for identifying cells deficient in GPI‐linked proteins and is, therefore, necessary for the diagnosis of PNH, to date there has not been an attempt to standardize the methodology used to identify these cells. Methods: In this document, we present a consensus effort that describes flow cytometric procedures for detecting PNH cells. Results: We discuss clinical indications and offer recommendations on data interpretation and reporting but mostly focus on analytical procedures important for analysis. We distinguish between routine analysis (defined as identifying an abnormal population of 1% or more) and high‐sensitivity analysis (in which as few as 0.01% PNH cells are detected). Antibody panels and gating strategies necessary for both procedures are presented in detail. We discuss methods for assessing PNH populations in both white blood cells and red blood cells and the relative advantages of measuring each. We present steps needed to validate the more elaborate high‐sensitivity techniques, including the need for careful titration of reagents and determination of background rates in normal populations, and discuss technical pitfalls that might affect interpretation. Conclusions: This document should both enable laboratories interested in beginning PNH testing to establish a valid procedure and allow experienced laboratories to improve their techniques. © 2010 Clinical Cytometry Society

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Metadata

Authors
Borowitz, M. J., Craig, F. E., DiGiuseppe, J. A., Illingworth, A. J., Rosse, W., Sutherland, D. R., Wittwer, C. T., & Richards, S. J.
Venue
Cytometry Part B: Clinical Cytometry
Publisher
Wiley
Published
2010-04-28
Volume
78B
Issue
4
Pages
211-230
ISSN
  • 1552-4949 (ISSN-L)
  • 1552-4957
OpenAlex
W2037350984
Cited by
403
References
40
FWCI
8.43
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Guidelines for the diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria and related disorders by flow cytometry. https://app.cochat.ai/papers/10.1002/cyto.b.20525
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Borowitz, M. J., Craig, F. E., DiGiuseppe, J. A., Illingworth, A. J., Rosse, W., Sutherland, D. R., Wittwer, C. T., & Richards, S. J. (2010). Guidelines for the diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria and related disorders by flow cytometry. Cytometry Part B: Clinical Cytometry. https://doi.org/10.1002/cyto.b.20525

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