Sysmex West & Central Africa
Menu

Monocytosis Workflow Optimisation

Where do you set your MONO# cut-off for smears? Balancing the burden of the smear workload with the risk of missing critical samples is not easy. The Monocytosis Workflow Optimisation (MWO) offers an evidence-based* optional rule set embedded in the Extended IPU to distinguish reactive monocytosis from monocytosis of suspected malignant origin.

Features

Monocytosis management – The dilemma with selecting the optimum criteria for morphological review

Existing criteria for monocytosis management differ in the MONO cut-off criteria - ISLH/GFHC suggest a smear review for MONO# > 1.5 x103/µL, while according to the WHO (2022), chronic myelomonocytic leukaemia (CMML), a rare leukaemia, is characterised by a MONO# ≥ 0.5 x 103/μL and ≥ 10% of the WBC count.

Reactive cases are most commonly the cause of monocytosis. However, there is a small possibility that the monocytosis is of malignant origin. This suspicion leads to microscopic examination, generating a high number of unnecessary smears. This leads to the dilemma of finding a balance between a significant increase of smears on false-positive samples to not miss a single case of suspected CMML and the reduction of the manual workload with the inherent risk of missing a rare abnormality due to a low sensitivity for CMML detection. 

The MWO concept - How does it work?

MWO combines the so-called ‘mono-dysplasia score’, the monocyte counts and information from the WDF scattergram to recommend samples with monocytosis for microscopic examination. 

The ‘mono-dysplasia score’, established and assessed by Schillinger et al., is calculated from three analytical components obtained from the WDF measurement in the search for dysplastic abnormalities typical for CMML.

Parameters

  • Mono #
  • Neut #/Mono #
  • NE-WX

Scatterplot showing the dispersion of the neutrophil population from which the NE-WX is obtained

 

References

*Schillinger F et al. (2018): A new approach for diagnosing chronic myelomonocytic leukemia using structural parameters of Sysmex XNTM analyzers in routine laboratory practice. Scand J Clin Lab Invest. Vol. 78(3):159–164.

Contacts
You have a question and would like to get in touch with our experts? We look forward to receiving your enquiry.

Sysmex West and Central Africa Ltd.

148A Marvel House, Giffard Road

Burma Camp – Trade Fair Road

East Cantonments, Accra Ghana

+233 3027 988 67

Documents

Product documents

Regulatory Documents

Regulatory documents, such as Instructions for Use, can be accessed with a valid My Sysmex login:

Go to My Sysmex

Explore more

BF Rules

BF Rules

Standardise your body fluid sample workflow

Details
Biomedical Validation

Biomedical Validation

Standardise your workflow for managing abnormal samples

Details
CBC-O

CBC-O

Discover the truth behind an increased MCHC

Details
Copyright © Sysmex Europe SE. All rights reserved.