Use Of A Flaer-Based Assay In The Screening Of PNH Clones In 867 Cases Of Anemia

Objective: To explore the significance of a Flaer-based WBC assay in the screening of PNH clones in patients with anemia.Method: This was a retrospective analysis of related clinical data in 867 patients with anemia.A total of 867 patients with anemia were collected from the outpatient and inpatient department of the first affiliated hospital of Zhengzhou University from August 2016 to October 2017,including 388 males and 479 females.The median age was 47 years old(from 8 months old to 89 years old).All patients met the diagnostic criteria for anemia.All patient samples submitted to the Flaer-based flow assay to detect PNH clones in the neutrophil and monocyte lineages and the CD59-based flow assay for PNH RBCs.Some of the patient samples submitted to the Ham test.Mann-whitney U rank sum test was used for comparison between quantitative data,and Wilcoxon rank sum test and Mcnemar rank sum test were used for comparison between paired data.Results: Among 867 patients with anemia,the positive rate of the Flaer-based flow assay was 10.03%(87 cases),that of the CD59-based flow assay was 4.96%(43 cases).The Flaer-based neutrophil assay was significantly different from the CD59-based flow assay and the Ham assay(?2=18.95,P<0.001;?2=56.02,P<0.001),the Flaer-based monocyte assay was significantly different from the CD59-based flow assay and the Ham assay(?2=20.57,P<0.001;?2=57.14,P<0.001),the rate of negative cells by the Flaer-based neutrophil and monocyte assay[(5.86�21.09)%,(5.99�20.98)%,(?x�s)%)] was higher than that of the CD59-based flow assay[(1.68�6.66)%],while there was no significant difference between the rates of negative cells by Flaer-based flow assay between granulocytes and monocytes(P=0.804).Among patients with PNH,the rate of negative cells by the Flaer-based flow assay[(73.94�28.59)%,(76.73�23.64)% ] was higher than that of the CD59-based flow assay[(11.15�21.56)% ](Z=-6.764,P<0.001;Z=-6.618,P<0.001),while the rates of Flaer-based flow assay between granulocytes and monocytes had no significant difference(Z=-0.085,P=0.933).Among the 87 patients with positive Flaer-based flow assay,the rate of negative cells by the Flaer-based flow assay in patients with PNH [(76.32�25.74)%,(75.40�25.61)% ] was higher than that of non-PNH patients[(14.00�24.10)%,(16.74�27.32)%](Z=-6.432,P<0.001;Z=-5.732,P<0.001).Conclusion: 1.The positive rate of the Flaer-based flow assay was higher than that of the CD59-based flow assay and the Ham test in the Screening of PNH Clones in 867 cases of anemia.2.Among patients with PNH,the rate of negative cells by the Flaer-based flow assay was higher than that of the CD59-based flow assay and the Ham test.3.The rate of negative cells by the Flaer-based flow assay in patients with PNH was higher than that of non-PNH patients.