Implementation of the Ogata flow cytometric scoring system in routine diagnostics of myelodysplastic syndrome

Background and Aims Compiling evidence has emerged for the relevance of flow cytometric assessment as a valuable part of the diagnostic work‐up of myelodysplastic syndrome (MDS). This study aimed at evaluating the implementation of a simple flow cytometric scoring system (FCSS), the Ogata score, in a routine diagnostic laboratory. Methods A total of 35 patient samples with a clinical suspicion of MDS were retrospectively assessed using the FCSS. The accuracy of the FCSS was evaluated on the basis of the final diagnoses of the patients. Results The final diagnoses included 17 MDS, 4 other myeloid cancers, and 14 reactive changes. Thirty‐two of 35 (91%) were correctly scored by the FCSS. All 3 incorrect scores were from samples classified as “other myeloid cancers.” Of the initial pathological evaluation of the bone marrows, 20% were inconclusive or incorrect. All inconclusive samples were correctly scored using the FCSS. Conclusion The FCSS evaluated here has high accuracy and low complexity. Cases with inconclusive pathological evaluation will especially potentially benefit from adding the Ogata score to the diagnostic work‐up. The system will be feasible to implement in most flow cytometry laboratories without the need for supplemental antibody panels. It should be emphasized that the FCSS, in our hands, provided poor discrimination between MDS and other myeloid clonal diseases.