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Olga Pozdnyakova, David M. Dorfman, Flow Cytometry Criteria for Systemic Mastocytosis: Bone Marrow Mast Cell Counts Do Not Always Count, American Journal of Clinical Pathology, Volume 139, Issue 3, March 2013, Pages 406–407, https://doi.org/10.1093/ajcp/139.3.406
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We would like to respond to the points raised by Sánchez-Muñoz et al regarding our article.
First, there are no inconsistencies between the number of patients with systemic mastocytosis (SM) and the number of analyzed specimens. The study included 23 patients with SM. However, 5 patients with SM had sequential flow cytometric studies. Because each sample was analyzed as a separate event, that resulted in a total of 39 SM specimens. Cases of monoclonal mast cell activation syndrome (MMCAS) were analyzed separately. Treatment information was beyond the scope of the study.
Second, we would like to point out that the presence of mast cell clusters by flow cytometry was 100% specific; no false-positive results were observed. All cases with mast cell clusters fulfilled the diagnostic criteria for SM based on biopsy findings and/or other laboratory findings. Discrete populations of mast cells were not observed in cases of MMCAS, cutaneous mastocytosis, anaphylaxis, or mast cell activation syndrome. We performed additional analyses of cases of Waldenström macroglobulinemia (WM; n = 23), myelodysplastic syndrome (MDS; n = 10), and recovering marrow (n = 3), and similarly, none of these cases showed clustering of mast cells or aberrant CD25/CD2 expression.
