The ICCS Advocacy Committee requests your participation in a Workload Survey for clinical flow cytometry laboratories. Changes since the publication of a prior workload survey (Wolniak et. al., Cytometry B Clin Cytom 2017;92:525 PMID 27363814) include new requirements from regulatory bodies, increased data dimensionality, higher test complexity, labor shortages, and reduced reimbursement.

The objectives of the current survey are to

- compare current workload volumes and staffing between laboratories

- assess the impact of increasing high complexity assays 

- assess the capacity of laboratories to implement high complexity assays

- assess the capacity of laboratories to meet applicable regulatory requirements


The intention is to publish an analysis of the results. The identity of the laboratories will be kept confidential and not be shared outside of the primary team of ICCS members conducting the data analysis. 

Important Definitions

  1. Medical Laboratory Technologist: (synonyms: laboratory technologist, medical laboratory scientist): all laboratory personnel qualified to perform high complexity testing in a flow cytometry laboratory, including running the cytometer, gating, and resulting of some assays, such as CD4 counts.
  2. Laboratory Assistant / Support Staff: Laboratory personnel who do not work on flow cytometers. They help the technologists with certain laboratory duties that do not involve staining or running the samples on the cytometer. It can include accessioning, sample preparation, etc.
  3. Supervisor / Manager / Coordinator: Laboratory personnel primarily responsible for directly supervising, training, hiring and mentoring laboratory staff, supervising the laboratory operations, competency assessments, and continuing education.
  4. Technical Development Specialists / Scientists: Laboratory personnel whose primary role in the flow laboratory is to develop and validate new flow cytometry assays.
  5. Flow Cytometric Testing: All assays that require the specimen to be run on a flow cytometer
  6. Non-flow Cytometric Testing (in a Flow Cytometry Laboratory): Any testing or duties performed by the same laboratory staff who performs flow cytometric testing, but does not require the specimen to be run on a flow cytometer. Examples are: Rotational coverage in other laboratories, such as Hematology or HLA, case accessioning, cytochemistry, aspirate smear and cytospin preparation, and iron staining of aspirate smears.
  7. Automated Sample Preparation: Any instrument/device that automates partial or all the steps involved in the preparation of a specimen before it is run on a cytometer.


3. Type of clinical flow cytometry laboratory. Choose the single best answer. *
4. What is the current composition of full time equivalents (FTEs) in your flow cytometry laboratory?  Enter the number for each category listed below. 

See Important Definitions above. 

Please do not include MDs or PhDs who provide interpretations/sign out/report cases or who serve as medical directors. *
 Enter the Number
4a. Medical Laboratory Technologists
4b. Laboratory Assistants and / or Support Staff
4c. Laboratory Managers / Supervisor / Coordinators
4d. Technical Development Specialists / Scientists
4e. Unfilled positions
7. Does your flow cytometry laboratory currently employ any FTEs with a specific flow cytometry certification (i.e., ASCP Specialist Certification in Cytometry [SCYM] or equivalent)?
12. What is the maximum number of fluorochromes/colors your flow laboratory uses per tube? Select the single best answer. *
13. Please provide approximate number of all flow cytometry testing performed per year for each category listed below. Enter “N/A” or “not sure” if most appropriate. *
 Type Your Answer
13a. Lymphocyte subset enumeration, including CD4 counts and/or B, T, and NK cell counts
13b. Absolute CD34 stem cell counts
13c. Complex immunodeficiency panels including lymphocyte subsets for memory B cells and T cells and/or functional assays
13d. Leukemia / Lymphoma panels, excluding MRD assays
13e. Paroxysmal nocturnal hemoglobinuria (PNH)
13f. Minimal residual disease for myeloid leukemias
13g. Minimal residual disease for plasma cell neoplasms
13h. Other minimal residual disease (lymphoblastic leukemias, chronic lymphocytic leukemia, mature B or T-cell lymphoma, etc.)
13i. Other (please list other tests and numbers per year)
14. What type(s) of automated sample preparation systems does your flow laboratory use? (select all that apply)
15. What types of antibody application processes are used for staining in your laboratory? *
 Most CommonlyOccasionallyRarely/Never
15a. Single antibody pipetting
15b. Liquid cocktail pipetting (prepared in-house)
15c. Liquid cocktail pipetting (purchased from vendor)
15d. Use of dried-down antibody tubes
16.  What is the estimated breakdown of flow cytometric duties covered by medical laboratory technologists in the following four areas?

Enter percentages for the categories below.   If the total percentage for the first four items does not add up to 100%, please enter the difference as "none of the above".
0/100 points
17. How often are “ad hoc” customized flow cytometry panels performed in your laboratory to accommodate special requests or troubleshoot issues? Select single best answer:
18. Among the professional staff (MD, DO, PhD), does your laboratory’s approach include a specific person or subset of people dedicated for interpretation/sign-out/reporting of more complex flow cytometry assays (e.g. minimal residual disease)?
18b. If YES, select one from the following option:
19. What are perceived barriers/constraints for timely new assay development in your flow cytometry laboratory? *
19a. Financial resources
19b. Staff number
19c. Level of experience among staff
19d. Lack of staff and/or time dedicated or protected for such work
19e. Specimen type and numbers for validation assays
19f. Add other barriers/constraints (specify below)
20. Please provide information about the flow cytometry laboratory hours of operation.
Note: each answer should not reflect more than 24 hours.
20d. Are technologists/laboratory staff on-call on non-holiday Saturdays?
20e. Are technologists/laboratory staff on-call on non-holiday Sundays?
20f. Are technologists/laboratory staff on-call to accommodate for holidays?
21. In your flow laboratory, what are indications for a specimen to be tested outside regular hours of operation? Select all that apply.
22. Please estimate how long it typically takes to introduce (design, validate, and implement) a new flow cytometry assay for your laboratory? *
 Number of Months or N/A
22a. Lymphoma/leukemia assay
22b. Minimal residual disease assay
22c. Enumeration assays (e.g. absolute CD34 counts, lymphocyte subsets)
23. What are the approaches in your laboratory for selecting panels for flow cytometry leukemia/lymphoma evaluations? Select all that apply.
24. Other than duplicate orders, do orders for flow cytometry get cancelled to avoid inappropriate testing?
25. What are the most significant changes implemented over the last 5 years that have helped your laboratory adapt to the increasingly high complexity testing? You may select up to three choices. *