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Abstract
Myelodysplastic syndromes/neoplasms (MDS) are a heterogeneous class of hematopoietic stem cell neoplasms characterized by ineffective hematopoiesis leading to peripheral cytopenias. This group of diseases is typically diagnosed using a combination of clinical, morphologic, and genetic criteria. Many studies have described the value of multiparametric flow cytometry (MFC) in the diagnosis, classification, and prognostication of MDS. This review summarizes the approach to MDS diagnosis and immunophenotypic characterization using MFC and describes the current state while highlighting future opportunities and potential pitfalls.
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Affiliation(s)
- Xueyan Chen
- Translational Science and Therapeutics Division, Fred Hutch Cancer Center, Seattle, WA, USA; Department of Laboratory Medicine and Pathology, University of Washington, 825 Eastlake Avenue East, Seattle, WA 98109, USA
| | - Ulrika Johansson
- SI-HMDS, Haematology, UHBW NHS Foundation Trust, Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - Sindhu Cherian
- Department of Laboratory Medicine and Pathology, University of Washington, 825 Eastlake Avenue East, Seattle, WA 98109, USA.
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2
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Porwit A, Béné MC, Duetz C, Matarraz S, Oelschlaegel U, Westers TM, Wagner-Ballon O, Kordasti S, Valent P, Preijers F, Alhan C, Bellos F, Bettelheim P, Burbury K, Chapuis N, Cremers E, Della Porta MG, Dunlop A, Eidenschink-Brodersen L, Font P, Fontenay M, Hobo W, Ireland R, Johansson U, Loken MR, Ogata K, Orfao A, Psarra K, Saft L, Subira D, Te Marvelde J, Wells DA, van der Velden VHJ, Kern W, van de Loosdrecht AA. Multiparameter flow cytometry in the evaluation of myelodysplasia: Analytical issues: Recommendations from the European LeukemiaNet/International Myelodysplastic Syndrome Flow Cytometry Working Group. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2023; 104:27-50. [PMID: 36537621 PMCID: PMC10107708 DOI: 10.1002/cyto.b.22108] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/20/2022] [Accepted: 11/29/2022] [Indexed: 01/18/2023]
Abstract
Multiparameter flow cytometry (MFC) is one of the essential ancillary methods in bone marrow (BM) investigation of patients with cytopenia and suspected myelodysplastic syndrome (MDS). MFC can also be applied in the follow-up of MDS patients undergoing treatment. This document summarizes recommendations from the International/European Leukemia Net Working Group for Flow Cytometry in Myelodysplastic Syndromes (ELN iMDS Flow) on the analytical issues in MFC for the diagnostic work-up of MDS. Recommendations for the analysis of several BM cell subsets such as myeloid precursors, maturing granulocytic and monocytic components and erythropoiesis are given. A core set of 17 markers identified as independently related to a cytomorphologic diagnosis of myelodysplasia is suggested as mandatory for MFC evaluation of BM in a patient with cytopenia. A myeloid precursor cell (CD34+ CD19- ) count >3% should be considered immunophenotypically indicative of myelodysplasia. However, MFC results should always be evaluated as part of an integrated hematopathology work-up. Looking forward, several machine-learning-based analytical tools of interest should be applied in parallel to conventional analytical methods to investigate their usefulness in integrated diagnostics, risk stratification, and potentially even in the evaluation of response to therapy, based on MFC data. In addition, compiling large uniform datasets is desirable, as most of the machine-learning-based methods tend to perform better with larger numbers of investigated samples, especially in such a heterogeneous disease as MDS.
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Affiliation(s)
- Anna Porwit
- Division of Oncology and Pathology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Marie C Béné
- Hematology Biology, Nantes University Hospital, CRCINA Inserm 1232, Nantes, France
| | - Carolien Duetz
- Department of Hematology, Amsterdam UMC, VU University Medical Center Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Sergio Matarraz
- Cancer Research Center (IBMCC-USAL/CSIC), Department of Medicine and Cytometry Service, Institute for Biomedical Research of Salamanca (IBSAL) and CIBERONC, University of Salamanca, Salamanca, Spain
| | - Uta Oelschlaegel
- Department of Internal Medicine, University Hospital Carl-Gustav-Carus, TU Dresden, Dresden, Germany
| | - Theresia M Westers
- Department of Hematology, Amsterdam UMC, VU University Medical Center Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Orianne Wagner-Ballon
- Department of Hematology and Immunology, Assistance Publique-Hôpitaux de Paris, University Hospital Henri Mondor, Créteil, France
- Inserm U955, Université Paris-Est Créteil, Créteil, France
| | | | - Peter Valent
- Department of Internal Medicine I, Division of Hematology & Hemostaseology and Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Frank Preijers
- Laboratory of Hematology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Canan Alhan
- Department of Hematology, Amsterdam UMC, VU University Medical Center Cancer Center Amsterdam, Amsterdam, The Netherlands
| | | | - Peter Bettelheim
- Department of Hematology, Ordensklinikum Linz, Elisabethinen, Linz, Austria
| | - Kate Burbury
- Department of Haematology, Peter MacCallum Cancer Centre, & University of Melbourne, Melbourne, Australia
| | - Nicolas Chapuis
- Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Cochin Hospital, Paris, France
- Institut Cochin, INSERM U1016, CNRS UMR, Université de Paris, Paris, France
| | - Eline Cremers
- Division of Hematology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Matteo G Della Porta
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alan Dunlop
- Department of Haemato-Oncology, Royal Marsden Hospital, London, UK
| | | | - Patricia Font
- Department of Hematology, Hospital General Universitario Gregorio Marañon-IiSGM, Madrid, Spain
| | - Michaela Fontenay
- Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Cochin Hospital, Paris, France
- Institut Cochin, INSERM U1016, CNRS UMR, Université de Paris, Paris, France
| | - Willemijn Hobo
- Department of Internal Medicine I, Division of Hematology & Hemostaseology and Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Robin Ireland
- Department of Haematology and SE-HMDS, King's College Hospital NHS Foundation Trust, London, UK
| | - Ulrika Johansson
- Laboratory Medicine, SI-HMDS, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Kiyoyuki Ogata
- Metropolitan Research and Treatment Centre for Blood Disorders (MRTC Japan), Tokyo, Japan
| | - Alberto Orfao
- Cancer Research Center (IBMCC-USAL/CSIC), Department of Medicine and Cytometry Service, Institute for Biomedical Research of Salamanca (IBSAL) and CIBERONC, University of Salamanca, Salamanca, Spain
| | - Katherina Psarra
- Department of Immunology - Histocompatibility, Evangelismos Hospital, Athens, Greece
| | - Leonie Saft
- Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital and Institute Solna, Stockholm, Sweden
| | - Dolores Subira
- Department of Hematology, Flow Cytometry Unit, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Jeroen Te Marvelde
- Laboratory Medical Immunology, Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Vincent H J van der Velden
- Laboratory Medical Immunology, Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Arjan A van de Loosdrecht
- Department of Hematology, Amsterdam UMC, VU University Medical Center Cancer Center Amsterdam, Amsterdam, The Netherlands
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Pembroke JS, Joseph JE, Smith SABC, Parker AJC, Jiang W, Sewell WA. Comparison of flow cytometry with other modalities in the diagnosis of myelodysplastic syndrome. Int J Lab Hematol 2021; 44:313-319. [PMID: 34841680 DOI: 10.1111/ijlh.13771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 10/14/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The myelodysplastic syndromes (MDSs) are heterogeneous myeloid malignancies, conventionally diagnosed by cytomorphology and cytogenetics, with an emerging role for flow cytometry. This study compared the performance of a 4-parameter flow cytometry scoring system, the Ogata Score, with other modalities in the diagnosis of MDS. METHODS Bone marrow aspirate and trephine biopsies from 238 patients performed to assess for possible MDS were analysed, and the flow cytometry score was retrospectively applied. The sensitivity and specificity of the flow cytometry score, the aspirate microscopy, the trephine microscopy with immunohistochemistry, and cytogenetic and molecular results were determined relative to the final diagnosis. RESULTS The medical records of the 238 patients were reviewed to determine the final clinical diagnosis made at the time of the bone marrow examination. This final diagnosis of MDS, possible MDS or not MDS, was based on clinical features and laboratory tests, including all parameters of the bone marrow investigation, except for the flow cytometry score, which was only determined for this study. The flow cytometry score was 67.4% sensitive and 93.8% specific. Aspirate microscopy had higher sensitivity (83.7%) and similar specificity (92.0%), whereas trephine microscopy had similar sensitivity (66.3%) and specificity (89.4%) to flow cytometry. Although the flow cytometry score had a lower sensitivity than aspirate microscopy, in 18 patients (7.6% of the total) the flow cytometry score was positive for MDS, whereas aspirate microscopy was negative or inconclusive. CONCLUSION The flow cytometry score and trephine microscopy exhibited reasonable sensitivity and high specificity, and complement aspirate microscopy in the assessment of MDS.
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Affiliation(s)
- John S Pembroke
- St Vincent's Clinical School, University of New South Wales Sydney, Sydney, Australia.,St Vincent's Pathology (SydPath), St Vincent's Hospital, Sydney, Australia
| | - Joanne E Joseph
- St Vincent's Clinical School, University of New South Wales Sydney, Sydney, Australia.,St Vincent's Pathology (SydPath), St Vincent's Hospital, Sydney, Australia.,Haematology Department, St Vincent's Hospital, Sydney, Australia
| | - Sandy A B C Smith
- St Vincent's Pathology (SydPath), St Vincent's Hospital, Sydney, Australia
| | - Andrew J C Parker
- St Vincent's Pathology (SydPath), St Vincent's Hospital, Sydney, Australia
| | - Wei Jiang
- St Vincent's Pathology (SydPath), St Vincent's Hospital, Sydney, Australia.,Haematology Department, St Vincent's Hospital, Sydney, Australia
| | - William A Sewell
- St Vincent's Clinical School, University of New South Wales Sydney, Sydney, Australia.,St Vincent's Pathology (SydPath), St Vincent's Hospital, Sydney, Australia.,Garvan Institute of Medical Research, Sydney, Australia
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Chauhan R, Singh J, Sharma C, Dange P, Chopra A, Mahapatra M, Pati H. The utility of a single tube 10-color flow cytometry for quantitative and qualitative analysis in myelodysplastic syndrome- a pilot study. Leuk Res 2021; 107:106651. [PMID: 34218155 DOI: 10.1016/j.leukres.2021.106651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 06/19/2021] [Accepted: 06/28/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Assessment of myelodysplasia (MDS) by flow cytometry (FCM) includes elaborate panels, and interpretation is observer-dependent. This study evaluates single tube 10-color FCM in a test cohort of clinically suspected MDS patients. METHODS We analyzed fifty-six bone marrow (BM) samples from clinically suspected MDS patients in a morphology-blinded manner along with controls using a 10-color single tube flow cytometry. We analyzed the reproducibility of Ogata score and modified FCM scores, additionally incorporating the proportion of CD15, CD11b, CD56, and CD38MFI on CD34+CD19-cluster for each patient. Patients were grouped as proven-MDS, suspected-MDS, and non-MDS groups based on morphology and cytogenetics. Optimized multi-axial radar-plots were also used to analyze maturation patterns in the granulocytic, monocytic, and blast progenitor compartments of proven-MDS cases and controls. RESULTS Flow cytometric abnormalities ≥3 were present in proven-MDS (n = 23) with a sensitivity and specificity of 78 % and 94 %, respectively, as per Ogata score. The addition of CD38 MFI to the score yielded sensitivity and specificity of 82 % and 88 %, respectively. Additional analysis of aberrant expression of CD15, CD11b, and CD56 increased the diagnostic power of the FCM score. A qualitative analysis of data also showed differences in maturation patterns in proven-MDS compared to the control group. CONCLUSION Single tube 10-color FCM scoring, including Ogata score, modified-FCM scores, and radar plots pattern analysis, showed significant abnormalities in proven-MDS cases in this pilot study. Large databases, including FCM-scoring and pattern-based analysis for normal BM maturation, could be further validated and standardized for screening MDS.
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Affiliation(s)
- Richa Chauhan
- Department of Hematology, Sir Ganga Ram Hospital, New Delhi, India
| | - Jay Singh
- Department of Laboratory Oncology, B.R.A.I.R.C.H., AIIMS, New Delhi, India
| | - Charu Sharma
- Department of Mathematics, Shiv Nadar University, Noida, U.P, India
| | - Prasad Dange
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Anita Chopra
- Department of Laboratory Oncology, B.R.A.I.R.C.H., AIIMS, New Delhi, India.
| | - Manoranjan Mahapatra
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Haraparasad Pati
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
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Alayed K, Meyerson JB, Osei ES, Blidaru G, Schlegelmilch J, Johnson M, Meyerson HJ. CD177 Enhances the Detection of Myelodysplastic Syndrome by Flow Cytometry. Am J Clin Pathol 2020; 153:554-565. [PMID: 32011681 DOI: 10.1093/ajcp/aqz196] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Previously we demonstrated that a decreased percentage of CD177-positive granulocytes detected by flow cytometry (FCM) was associated with myelodysplastic syndrome (MDS). Here we expand on those findings to more rigorously evaluate the utility of CD177 for the detection of MDS. METHODS Two hundred patient samples (100 MDS and 100 controls) were evaluated for granulocyte expression of CD177 and 11 other flow cytometric parameters known to be associated with MDS. RESULTS We show that CD177, as a single analyte, is highly correlated with MDS with a receiver operating characteristic area under curve value of 0.8. CD177 expression below 30% demonstrated a sensitivity of 51% and a specificity of 94% for detecting MDS with a positive predictive value of 89.5%. In multivariate analysis of 12 MDS-associated FCM metrics, CD177 and the Ogata parameters were significant indicators of MDS, and CD177 increased sensitivity of the Ogata score by 16% (63%-79%) for predicting MDS. Finally, diagnostic criteria incorporating these parameters with a 1% blast cutoff level and CD177 resulted in a sensitivity of 90% and specificity of 91% for detecting MDS. CONCLUSIONS The findings indicate CD177 is a useful FCM marker for MDS.
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Affiliation(s)
- Khaled Alayed
- Department of Pathology, King Saud University, Riyadh, Saudi Arabia
| | | | - Ebenezer S Osei
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Georgeta Blidaru
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | | | - Michael Johnson
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Howard J Meyerson
- Department of Pathology, Case Western Reserve University, Cleveland, OH
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Grille Montauban S, Hernandez‐Perez CR, Velloso EDRP, Novoa V, Lorand‐Metze I, Gonzalez J, Solari L, Cismondi V, Serrano JC, Burgnini A, Rabelo‐Carrasco LJ, Bacal N, Trias N, Guevara R, Rico Vido J, Crisp R, Enrico A, Boada M, Pereira Cunha FG, Fanessi V, Venegas MB, Issouribehere D, Novoa A, Lens D. Flow cytometry “Ogata score” for the diagnosis of myelodysplastic syndromes in a real‐life setting. A Latin American experience. Int J Lab Hematol 2019; 41:536-541. [DOI: 10.1111/ijlh.13047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/15/2019] [Accepted: 04/18/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Sofía Grille Montauban
- Facultad de Medicina, Cátedra de Hematología, Hospital de Clínicas Universidad de la República Montevideo Uruguay
- Facultad de Medicina, Laboratorio de Citometría y Biología Molecular, Hospital de Clínicas Universidad de la República Montevideo Uruguay
| | | | - Elvira D. R. P. Velloso
- Hospital das Clínicas da FMUSP Sao Paulo Brazil
- Hospital Israelita Albert Einstein Sao Paulo Brazil
| | - Viviana Novoa
- Laboratorio de Inmunología, Unidad de Inmunología e Histocompatibilidad Hospital Gral. de Agudos Dr. Carlos G. Durand Buenos Aires Argentina
| | | | - Jaqueline Gonzalez
- Servicio de Hematología Hospital General de Agudos. Dr. Carlos G. Durand Buenos Aires Argentina
| | - Liliana Solari
- Laboratorio de Citometría, Departamento de Diagnóstico Hospital Nacional Posadas El Palomar Argentina
| | - Valeria Cismondi
- S.A.M.I.C, Laboratorio de Citometría Hospital El Cruce "Nestor Carlos Kirchner" Florencio Varela Buenos Aires Argentina
| | | | - Andreína Burgnini
- Facultad de Medicina, Laboratorio de Citometría y Biología Molecular, Hospital de Clínicas Universidad de la República Montevideo Uruguay
| | | | - Nydia Bacal
- Hospital das Clínicas da FMUSP Sao Paulo Brazil
- Centro de Hematologia de São Paulo São Paulo Brazil
| | - Natalia Trias
- Facultad de Medicina, Laboratorio de Citometría y Biología Molecular, Hospital de Clínicas Universidad de la República Montevideo Uruguay
| | - Romina Guevara
- Laboratorio de Inmunología, Unidad de Inmunología e Histocompatibilidad Hospital Gral. de Agudos Dr. Carlos G. Durand Buenos Aires Argentina
- Centro de Diagnóstico Molecular Laboratorio Citometría de Flujo Buenos Aires Argentina
| | - Joyce Rico Vido
- Hematology ‐ Hemotherapy Center University of Campinas Campinas Brazil
| | - Renee Crisp
- Servicio de Hematología Hospital Nacional Posadas El Palomar Argentina
| | - Alicia Enrico
- Area de Hematología Hospital Italiano de La Plata La Plata Argentina
| | - Matilde Boada
- Facultad de Medicina, Cátedra de Hematología, Hospital de Clínicas Universidad de la República Montevideo Uruguay
- Facultad de Medicina, Laboratorio de Citometría y Biología Molecular, Hospital de Clínicas Universidad de la República Montevideo Uruguay
| | | | - Viviana Fanessi
- S.A.M.I.C, Laboratorio de Citometría Hospital El Cruce "Nestor Carlos Kirchner" Florencio Varela Buenos Aires Argentina
| | - María Belén Venegas
- Laboratorio de Citometría, Departamento de Diagnóstico Hospital Nacional Posadas El Palomar Argentina
| | - Diego Issouribehere
- S.A.M.I.C, Laboratorio de Citometría Hospital El Cruce "Nestor Carlos Kirchner" Florencio Varela Buenos Aires Argentina
| | - Andrea Novoa
- Centro de Diagnóstico Molecular Laboratorio Citometría de Flujo Buenos Aires Argentina
| | - Daniela Lens
- Facultad de Medicina, Laboratorio de Citometría y Biología Molecular, Hospital de Clínicas Universidad de la República Montevideo Uruguay
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Aires A, Teixeira MDA, Lau C, Moreira C, Spínola A, Mota A, Freitas I, Coutinho J, Lima M. A pilot study on the usefulness of peripheral blood flow cytometry for the diagnosis of lower risk myelodysplastic syndromes: the "MDS thermometer". BMC HEMATOLOGY 2018; 18:6. [PMID: 29564138 PMCID: PMC5850915 DOI: 10.1186/s12878-018-0101-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 03/01/2018] [Indexed: 12/15/2022]
Abstract
Background Immunophenotypic analysis of the bone marrow (BM) cells has proven to be helpful in the diagnosis of Myelodysplastic Syndromes (MDS). However, the usefulness of flow cytometry (FCM) for the detection of myelodysplasia in the peripheral blood (PB) still needs to be investigated. The aim of this pilot study was to evaluate the value of FCM-based PB neutrophil and monocyte immunophenotyping for the diagnosis of lower risk MDS (LR-MDS). Methods We evaluated by 8-color FCM the expression of multiple cell surface molecules (CD10, CD11b, CD11c, CD13, CD14, CD15, CD16, CD34, CD45, CD56, CD64 and HLA-DR) in PB neutrophils and monocytes from a series of 14 adult LR-MDS patients versus 14 normal individuals. Results Peripheral blood neutrophils from patients with LR-MDS frequently had low forward scatter (FSC) and side scatter (SSC) values and low levels of CD11b, CD11c, CD10, CD16, CD13 and CD45 expression, in that order, as compared to normal neutrophils. In addition, patients with LR-MDS commonly display a higher fraction of CD14+CD56+ and a lower fraction of CD14+CD16+ monocytes in the PB. Based on these results, we proposed an immunophenotyping score based on which PB samples from patients with LR-MDS could be distinguished from normal PB samples with a sensitivity 93% and a specificity of 100%. In addition, we used this score to construct the MDS Thermometer, a screening tool for detection and monitoring of MDS in the PB in clinical practice. Conclusions Peripheral blood neutrophil and monocyte immunophenotyping provide useful information for the diagnosis of LR-MDS, as a complement to cytomorphology. If validated by subsequent studies in larger series of MDS patients and extended to non-MDS patients with cytopenias, our findings may improve the diagnostic assessment and avoid invasive procedures in selected groups of MDS patients. Electronic supplementary material The online version of this article (10.1186/s12878-018-0101-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ana Aires
- 1Department of Hematology, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Porto, Portugal.,3Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS/UP), Porto, Portugal
| | - Maria Dos Anjos Teixeira
- 1Department of Hematology, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Porto, Portugal.,4Unidade Multidisciplinar de Investigação Biomédica, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (UMIB/ICBAS/UP), Porto, Portugal.,Laboratório de Citometria, Serviço de Hematologia, Hospital de Santo António, Centro Hospitalar do Porto, instalações do Ex-CICAP, Rua D. Manuel II, s/n, 4099-001 Porto, Portugal
| | - Catarina Lau
- 1Department of Hematology, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Porto, Portugal.,4Unidade Multidisciplinar de Investigação Biomédica, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (UMIB/ICBAS/UP), Porto, Portugal.,Laboratório de Citometria, Serviço de Hematologia, Hospital de Santo António, Centro Hospitalar do Porto, instalações do Ex-CICAP, Rua D. Manuel II, s/n, 4099-001 Porto, Portugal
| | - Cláudia Moreira
- 1Department of Hematology, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Porto, Portugal
| | - Ana Spínola
- 1Department of Hematology, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Porto, Portugal
| | - Alexandra Mota
- 1Department of Hematology, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Porto, Portugal.,3Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS/UP), Porto, Portugal
| | - Inês Freitas
- 2Department of Pathology, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Porto, Portugal.,4Unidade Multidisciplinar de Investigação Biomédica, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (UMIB/ICBAS/UP), Porto, Portugal
| | - Jorge Coutinho
- 1Department of Hematology, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Porto, Portugal
| | - Margarida Lima
- 1Department of Hematology, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Porto, Portugal.,3Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS/UP), Porto, Portugal.,4Unidade Multidisciplinar de Investigação Biomédica, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (UMIB/ICBAS/UP), Porto, Portugal.,Laboratório de Citometria, Serviço de Hematologia, Hospital de Santo António, Centro Hospitalar do Porto, instalações do Ex-CICAP, Rua D. Manuel II, s/n, 4099-001 Porto, Portugal
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Kárai B, Bedekovics J, Miltényi Z, Gergely L, Szerafin L, Ujfalusi A, Kappelmayer J, Hevessy Z. A single-tube flow cytometric procedure for enhancing the diagnosis and prognostic classification of patients with myelodysplastic syndromes. Int J Lab Hematol 2017. [DOI: 10.1111/ijlh.12700] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- B. Kárai
- Department of Laboratory Medicine; Faculty of Medicine; University of Debrecen; Debrecen Hungary
| | - J. Bedekovics
- Department of Pathology; Faculty of Medicine; University of Debrecen; Debrecen Hungary
| | - Zs. Miltényi
- Department of Medicine; Faculty of Medicine; University of Debrecen; Debrecen Hungary
| | - L. Gergely
- Department of Medicine; Faculty of Medicine; University of Debrecen; Debrecen Hungary
| | - L. Szerafin
- Department of Hematology; Jósa András County Hospital; Nyíregyháza Hungary
| | - A. Ujfalusi
- Department of Laboratory Medicine; Faculty of Medicine; University of Debrecen; Debrecen Hungary
| | - J. Kappelmayer
- Department of Laboratory Medicine; Faculty of Medicine; University of Debrecen; Debrecen Hungary
| | - Zs. Hevessy
- Department of Laboratory Medicine; Faculty of Medicine; University of Debrecen; Debrecen Hungary
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Porwit A. Is There a Role for Flow Cytometry in the Evaluation of Patients With Myelodysplastic Syndromes? Curr Hematol Malig Rep 2015; 10:309-17. [DOI: 10.1007/s11899-015-0272-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Reis-Alves SC, Traina F, Metze K, Lorand-Metze I. Improving the differential diagnosis between myelodysplastic syndromes and reactive peripheral cytopenias by multiparametric flow cytometry: the role of B-cell precursors. Diagn Pathol 2015; 10:44. [PMID: 25924846 PMCID: PMC4428240 DOI: 10.1186/s13000-015-0259-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 03/31/2015] [Indexed: 11/17/2022] Open
Abstract
Background Immunophenotyping is a valuable ancillary technique for the differential diagnosis between myelodysplastic syndromes (MDS) with low bone marrow (BM) blast counts and a normal karyotype, and reactive peripheral (PB) cytopenias. Our aim was to search for the most important variables for this purpose. We also analyzed the age variation of BM B-cell precursors (BCP) and its differences in reactive and clonal cytopenias. Methods Immunophenotypic analyzes were performed in BM of 54 patients with MDS (76% with BM blasts <5%) and 35 cases of reactive cytopenias. Healthy allogeneic BM transplantation donors (n = 41) were used as controls. We used a four-color panel of antibodies analyzing 9 granulocytic, 8 monocytic and 6 CD34+ cell features. Results Asynchronous shift to the left in maturing granulocytes and increase in CD16+ monocytes were also found in reactive PB cytopenias, but the most important aberrancies in MDS were seen in myeloid CD34+ cells. Decrease in BCP, that is a hallmark of MDS, could also be found in reactive cytopenias, especially in patients >55 years. % BM BCP could be calculated by the formula: (−7.97 × log age) + (4.24 × log % CD34+cells) – (0.22 x nr. alterations CD34+cells) + 0.577. Corrected R2 = 0.467. Conclusion Analysis of myelomonocytic precursors and CD34+ cells was satisfactory for the differential diagnosis between reactive PB cytopenias and MDS. The most specific alterations were found in CD34+ cells. Comparison of the values obtained with those of normal age-matched controls is recommended.
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Affiliation(s)
- Suiellen C Reis-Alves
- Hematology and Hemotherapy Center, University of Campinas, Carlos Chagas Street, 480, 13083-878 Campinas, São Paulo, Brazil.
| | - Fabiola Traina
- Faculty of Medicine of Ribeirão Preto, University of São Paulo, Vila Monte Alegre, 14048-900, Ribeirão Preto, Sao Paulo, Brazil.
| | - Konradin Metze
- Faculty of Medicine, University of Campinas, Tessália Vieira de Camargo Street 126, 13083-887, Campinas, São Paulo, Brazil.
| | - Irene Lorand-Metze
- Hematology and Hemotherapy Center, University of Campinas, Carlos Chagas Street, 480, 13083-878 Campinas, São Paulo, Brazil. .,Faculty of Medicine, University of Campinas, Tessália Vieira de Camargo Street 126, 13083-887, Campinas, São Paulo, Brazil.
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11
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Porwit A, van de Loosdrecht AA, Bettelheim P, Brodersen LE, Burbury K, Cremers E, Della Porta MG, Ireland R, Johansson U, Matarraz S, Ogata K, Orfao A, Preijers F, Psarra K, Subirá D, Valent P, van der Velden VHJ, Wells D, Westers TM, Kern W, Béné MC. Revisiting guidelines for integration of flow cytometry results in the WHO classification of myelodysplastic syndromes-proposal from the International/European LeukemiaNet Working Group for Flow Cytometry in MDS. Leukemia 2014; 28:1793-8. [PMID: 24919805 DOI: 10.1038/leu.2014.191] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 04/06/2014] [Accepted: 05/02/2014] [Indexed: 12/22/2022]
Abstract
Definite progress has been made in the exploration of myelodysplastic syndromes (MDS) by flow cytometry (FCM) since the publication of the World Health Organization 2008 classification of myeloid neoplasms. An international working party initiated within the European LeukemiaNet and extended to include members from Australia, Canada, Japan, Taiwan and the United States has, through several workshops, developed and subsequently published consensus recommendations. The latter deal with preanalytical precautions, and propose small and large panels, which allow evaluating immunophenotypic anomalies and calculating myelodysplasia scores. The current paper provides guidelines that strongly recommend the integration of FCM data with other diagnostic tools in the diagnostic work-up of MDS.
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Affiliation(s)
- A Porwit
- Department of Pathobiology and Laboratory Medicine, University of Toronto, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
| | - A A van de Loosdrecht
- Department of Hematology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - P Bettelheim
- First Medical Department, Elisabethinen Hospital, Linz, Austria
| | | | - K Burbury
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, Melbourne, Victoria, Australia
| | - E Cremers
- Department of Hematology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - M G Della Porta
- Department of Hematology and Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, and University of Pavia, Pavia, Italy
| | | | | | - S Matarraz
- Servicio Central de Citometría, Centro de Investigación del Cáncer, Instituto de Biologia Celular y Molecular del Cáncer CSIC/USAL/IBSAL) and Department of Medicine, Universidad de Salamanca, Salamanca, Spain
| | - K Ogata
- Metropolitan Research Center for Blood Disorders MRC JAPAN, Midorigaoka, Chofu, Tokyo, Japan
| | - A Orfao
- Servicio Central de Citometría, Centro de Investigación del Cáncer, Instituto de Biologia Celular y Molecular del Cáncer CSIC/USAL/IBSAL) and Department of Medicine, Universidad de Salamanca, Salamanca, Spain
| | - F Preijers
- Department of Hematology, St Radboud University Medical Center, Nijmegen, The Netherlands
| | - K Psarra
- Department of Immunology-Histocompatibility, Evangelismos Hospital, Athens, Greece
| | - D Subirá
- Department of Hematology, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - P Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology and Ludwig Boltzmann Cluster Oncology, Medical University of Vienna, Vienna, Austria
| | - V H J van der Velden
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - D Wells
- HematoLogics, Inc., Seattle, WA, USA
| | - T M Westers
- Department of Hematology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - W Kern
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - M C Béné
- Service d'Hématologie Biologique, CHU de Nantes, Nantes, France
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