{
  "abstract": "INTRODUCTION: Monocytosis is a frequent trigger for blood smear review in a routine hematology laboratory whereas chronic myelomonocytic leukemia (CMML) is infrequent and arises mostly in elderly patients. In order to define the best workflow for monocytosis, we studied three diagnostic approaches: the classical morphology approach (blood smear review), the flow cytometry assay (quantification of monocyte subsets as described by Selimoglu-Buet et al in 2015), and the \"mono-dysplasia-score\" also referred to as \"Monoscore (as described by our team in 2018 using the structural parameters of the Sysmex XN™ analyzers). METHODS: Studying a multicentric cohort of 196 nonclonal monocytoses and CMML patients aged over 50 years, we compared the diagnostic performance of the three approaches alone and in combination to propose a diagnostic decision tree. RESULTS: In patients presenting with additional criteria for slide review to monocytosis (37% of our cohort), we propose to sequentially combine morphology, Monoscore, and flow cytometry. On the contrary, for patients with isolated monocytosis (63%), slide review is not mandatory and we suggest performing flow cytometry depending on the Monoscore value. Using the proposed algorithm, 98% of CMML patients would have been correctly identified, slide review rate drastically reduced, and flow cytometry would have been carried out in 44% of patients. CONCLUSION: We have shown that implementation of Monoscore is a useful input filter to significantly reduce slide reviews without losing sensitivity and that flow cytometry is a performant technique in the second step of the diagnostic workup of CMML.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "name": "Clauser S"
    },
    {
      "name": "Maillon A"
    },
    {
      "name": "Capron C"
    },
    {
      "name": "Jondeau K"
    },
    {
      "name": "Ronez E"
    },
    {
      "name": "Schillinger F"
    },
    {
      "name": "Garnache-Ottou F"
    },
    {
      "name": "Cornet E"
    },
    {
      "name": "Valérie Bardet"
    },
    {
      "name": "Zhu J"
    },
    {
      "name": "Sourdeau E"
    },
    {
      "name": "Aubert H"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2vha7qv5bzyfk.bib",
  "cited_by": 10,
  "doi": "10.1111/ijlh.13115",
  "fulltext_url": null,
  "id": "2vha7qv5bzyfk",
  "issns": [
    "1751-5521",
    "1365-2257"
  ],
  "landing_url": "https://hal.science/hal-05785527v1",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.mhep"
    ],
    [
      "hal",
      "2.sdv.mhep.hem"
    ],
    [
      "openalex",
      "2716|Myeloproliferative Neoplasms: Diagnosis and Treatment"
    ]
  ],
  "openalex": "W2982139208",
  "pdf_url": "https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ijlh.13115",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-08",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/2vha7qv5bzyfk.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:50Z",
      "native_id": "hal-05785527",
      "source": "hal",
      "url": "https://hal.science/hal-05785527v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2716|Myeloproliferative Neoplasms: Diagnosis and Treatment",
      "subfield": "human-genetics"
    }
  ],
  "title": "A hierarchical approach in the diagnostic workflow of chronic myelomonocytic leukemia: Pivotal role of the \"Mono-dysplasia-score\" combined with flow cytometric quantification of monocyte subsets.",
  "title_text": "A hierarchical approach in the diagnostic workflow of chronic myelomonocytic leukemia: Pivotal role of the \"Mono-dysplasia-score\" combined with flow cytometric quantification of monocyte subsets.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:50Z",
  "url": "https://research.draconitic.com/paper/2vha7qv5bzyfk",
  "venue": "International Journal of Laboratory Hematology",
  "versions": []
}