1
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Raddi MG, Bencini S, Peruzzi B, Mattiuz G, De Pourcq S, Tanturli M, Chapuis N, Consagra A, Rigodanza L, Amato C, Sanna A, Tofacchi E, Attardi E, Park S, Kosmider O, Annunziato F, Fontenay M, Santini V. Flow cytometric analysis of erythroid precursors and mutational signatures of lower risk myelodysplastic syndromes identify responders to erythroid stimulating agents. Blood Cancer J 2024; 14:127. [PMID: 39112451 PMCID: PMC11306215 DOI: 10.1038/s41408-024-01112-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 08/10/2024] Open
Affiliation(s)
- Marco G Raddi
- MDS Unit, DMSC, AOU Careggi, University of Florence, Florence, Italy
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Sara Bencini
- Flow Cytometry and Immunotherapy Diagnostic Center, AOU Careggi, Florence, Italy
| | - Benedetta Peruzzi
- Flow Cytometry and Immunotherapy Diagnostic Center, AOU Careggi, Florence, Italy
| | - Giorgio Mattiuz
- MDS Unit, DMSC, AOU Careggi, University of Florence, Florence, Italy
| | - Sven De Pourcq
- MDS Unit, DMSC, AOU Careggi, University of Florence, Florence, Italy
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Michele Tanturli
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Nicolas Chapuis
- Université Paris Cité and Assistance Publique-Hôpitaux de Paris. Hôpital Cochin, Laboratory of Hematology, Paris, France
| | - Angela Consagra
- MDS Unit, DMSC, AOU Careggi, University of Florence, Florence, Italy
| | - Luca Rigodanza
- MDS Unit, DMSC, AOU Careggi, University of Florence, Florence, Italy
- AOU Careggi, Hematology department, Florence, Italy
| | - Cristina Amato
- MDS Unit, DMSC, AOU Careggi, University of Florence, Florence, Italy
| | | | - Elena Tofacchi
- MDS Unit, DMSC, AOU Careggi, University of Florence, Florence, Italy
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Enrico Attardi
- MDS Unit, DMSC, AOU Careggi, University of Florence, Florence, Italy
| | - Sophie Park
- Grenoble Alpes Hospital, Hematology Department, University Grenoble Alpes, Grenoble, France
| | - Olivier Kosmider
- Université Paris Cité and Assistance Publique-Hôpitaux de Paris. Hôpital Cochin, Laboratory of Hematology, Paris, France
| | - Francesco Annunziato
- Flow Cytometry and Immunotherapy Diagnostic Center, AOU Careggi, Florence, Italy
- Department of Experimental and Clinical Medicine and DENOTHE Center, University of Florence, Florence, Italy
| | - Michaela Fontenay
- Université Paris Cité and Assistance Publique-Hôpitaux de Paris. Hôpital Cochin, Laboratory of Hematology, Paris, France
| | - Valeria Santini
- MDS Unit, DMSC, AOU Careggi, University of Florence, Florence, Italy.
- AOU Careggi, Hematology department, Florence, Italy.
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2
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Boccia R, Xiao H, von Wilamowitz-Moellendorff C, Raorane R, Deshpande S, Klijn SL, Yucel A. A Systematic Literature Review of Predictors of Erythropoiesis-Stimulating Agent Failure in Lower-Risk Myelodysplastic Syndromes. J Clin Med 2024; 13:2702. [PMID: 38731231 PMCID: PMC11084325 DOI: 10.3390/jcm13092702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/04/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Erythropoiesis-stimulating agents (ESAs) are the first-line treatment option for anemia in patients with lower-risk myelodysplastic syndromes (LR-MDS). A systematic literature review was conducted to identify evidence of the association between prognostic factors and ESA response/failure in LR-MDS. MEDLINE, Embase, and relevant conferences were searched systematically for studies assessing the association between prognostic factors and ESA response/failure in adult patients. Of 1566 citations identified, 38 were included. Patient risk status in studies published from 2000 onwards was commonly assessed using the International Prognostic Scoring System (IPSS) or revised IPSS. ESA response was generally assessed using the International Working Group MDS criteria. Among the included studies, statistically significant relationships were found, in both univariate and multivariate analyses, between ESA response and the following prognostic factors: higher hemoglobin levels, lower serum erythropoietin levels, and transfusion independence. Furthermore, other prognostic factors such as age, bone marrow blasts, serum ferritin level, IPSS risk status, and karyotype status did not demonstrate statistically significant relationships with ESA response. This systematic literature review has confirmed prognostic factors of ESA response/failure. Guidance to correctly identify patients with these characteristics could be helpful for clinicians to provide optimal treatment.
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Affiliation(s)
- Ralph Boccia
- The Center for Cancer and Blood Disorders, 6410 Rockledge Drive, Suite 660, Bethesda, MD 20817, USA
| | - Hong Xiao
- Bristol Myers Squibb, 3401 Princeton Pike, Lawrence Township, NJ 08648, USA; (H.X.)
| | | | - Renuka Raorane
- Evidera, Ltd., UK Office, The Ark, 201 Talgarth Rd, London W6 8BJ, UK; (C.v.W.-M.); (R.R.)
| | - Sohan Deshpande
- Evidera, Ltd., UK Office, The Ark, 201 Talgarth Rd, London W6 8BJ, UK; (C.v.W.-M.); (R.R.)
| | - Sven L. Klijn
- Bristol Myers Squibb, 3401 Princeton Pike, Lawrence Township, NJ 08648, USA; (H.X.)
| | - Aylin Yucel
- Bristol Myers Squibb, 3401 Princeton Pike, Lawrence Township, NJ 08648, USA; (H.X.)
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3
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Dussiau C, Comont T, Knosp C, Vergnolle I, Bravetti C, Canali A, Houvert A, Largeaud L, Daveaux C, Zaroili L, Friedrich C, Boussaid I, Zalmai L, Almire C, Rauzy O, Willems L, Birsen R, Bouscary D, Fontenay M, Kosmider O, Chapuis N, Vergez F. Loss of hematopoietic progenitors heterogeneity is an adverse prognostic factor in lower-risk myelodysplastic neoplasms. Leukemia 2024; 38:1131-1142. [PMID: 38575672 DOI: 10.1038/s41375-024-02234-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/06/2024]
Abstract
Myelodysplastic neoplasms (MDS) are characterized by clonal evolution starting from the compartment of hematopoietic stem and progenitors cells (HSPCs), leading in some cases to leukemic transformation. We hypothesized that deciphering the diversity of the HSPCs compartment may allow for the early detection of an emergent sub-clone that drives disease progression. Deep analysis of HSPCs repartition by multiparametric flow cytometry revealed a strong disorder of the hematopoietic branching system in most patients at diagnosis with different phenotypic signatures closely related to specific MDS features. In two independent cohorts of 131 and 584 MDS, the HSPCs heterogeneity quantified through entropy calculation was decreased in 47% and 46% of cases, reflecting a more advanced state of the disease with deeper cytopenias, higher IPSS-R risk and accumulation of somatic mutations. We demonstrated that patients with lower-risk MDS and low CD34 + CD38+HSPCs entropy had an adverse outcome and that this parameter is as an independent predictive biomarker for progression free survival, leukemia free survival and overall survival. Analysis of HSPCs repartition at diagnosis represents therefore a very powerful tool to identify lower-risk MDS patients with a worse outcome and valuable for clinical decision-making, which could be fully integrated in the MDS diagnostic workflow.
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Affiliation(s)
- Charles Dussiau
- Assistance Publique-Hôpitaux de Paris. Centre-Université Paris Cité, Service d'hématologie biologique, Hôpital Cochin, Paris, France
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
| | - Thibault Comont
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service de Médecine Interne, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
| | - Camille Knosp
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
| | - Inès Vergnolle
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Laboratoire d'Hématologie, Toulouse, France
| | - Clotilde Bravetti
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
| | - Alban Canali
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Laboratoire d'Hématologie, Toulouse, France
| | - Amandine Houvert
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
| | - Laetitia Largeaud
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Laboratoire d'Hématologie, Toulouse, France
| | - Christian Daveaux
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
| | - Laila Zaroili
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
| | - Chloé Friedrich
- Assistance Publique-Hôpitaux de Paris. Centre-Université Paris Cité, Service d'hématologie biologique, Hôpital Cochin, Paris, France
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
| | - Ismaël Boussaid
- Assistance Publique-Hôpitaux de Paris. Centre-Université Paris Cité, Service d'hématologie biologique, Hôpital Cochin, Paris, France
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
| | - Loria Zalmai
- Assistance Publique-Hôpitaux de Paris. Centre-Université Paris Cité, Service d'hématologie biologique, Hôpital Cochin, Paris, France
| | - Carole Almire
- Assistance Publique-Hôpitaux de Paris. Centre-Université Paris Cité, Service d'hématologie biologique, Hôpital Cochin, Paris, France
| | - Odile Rauzy
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service de Médecine Interne, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
| | - Lise Willems
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
- Assistance Publique-Hôpitaux de Paris. Centre-Université Paris Cité, Service d'hématologie clinique, Hôpital Cochin, Paris, France
| | - Rudy Birsen
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
- Assistance Publique-Hôpitaux de Paris. Centre-Université Paris Cité, Service d'hématologie clinique, Hôpital Cochin, Paris, France
| | - Didier Bouscary
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
- Assistance Publique-Hôpitaux de Paris. Centre-Université Paris Cité, Service d'hématologie clinique, Hôpital Cochin, Paris, France
| | - Michaela Fontenay
- Assistance Publique-Hôpitaux de Paris. Centre-Université Paris Cité, Service d'hématologie biologique, Hôpital Cochin, Paris, France
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
| | - Olivier Kosmider
- Assistance Publique-Hôpitaux de Paris. Centre-Université Paris Cité, Service d'hématologie biologique, Hôpital Cochin, Paris, France
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France
| | - Nicolas Chapuis
- Assistance Publique-Hôpitaux de Paris. Centre-Université Paris Cité, Service d'hématologie biologique, Hôpital Cochin, Paris, France.
- Université Paris Cité, Institut Cochin, CNRSUMR8104, INSERM U1016, Paris, France.
| | - François Vergez
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Laboratoire d'Hématologie, Toulouse, France
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Sorigue M. Diagnosis of erythroid dysplasia by flow cytometry: a review. Expert Rev Hematol 2023; 16:1049-1062. [PMID: 38018383 DOI: 10.1080/17474086.2023.2289534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/27/2023] [Indexed: 11/30/2023]
Abstract
INTRODUCTION The diagnosis of myelodysplastic syndrome (MDS) is complex. Flow cytometric analysis of the myelomonocytic compartment can be helpful, but it is highly subjective and reproducibility by non-specialized groups is unclear. Analysis of the erythroid lineage by flow cytometry is emerging as potentially more reproducible and easier to conduct, while keeping a high diagnostic performance. AREAS COVERED We review the evidence in this area, including 1) the use of well-established markers - CD71 and CD36 - and other less well-established markers and parameters; 2) the use of flow cytometric scores for the erythroid lineage; and 3) additional aspects, including the emergence of computational tools and the roles of flow cytometry beyond diagnosis. Finally, we discuss the limitations with the current evidence, including 1) the impact of the sample processing protocol and reagents on the results, 2) the lack of a standard gating strategy, and 3) conceptualization and design issues in the available publications. EXPERT OPINION We end by offering our recommendations for the current use - and our personal take on the value - of the analysis of erythroid lineage by flow cytometry.
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Affiliation(s)
- Marc Sorigue
- Medical Department, Trialing Health, Barcelona, Spain
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5
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van de Loosdrecht AA, Kern W, Porwit A, Valent P, Kordasti S, Cremers E, Alhan C, Duetz C, Dunlop A, Hobo W, Preijers F, Wagner-Ballon O, Chapuis N, Fontenay M, Bettelheim P, Eidenschink-Brodersen L, Font P, Johansson U, Loken MR, Te Marvelde JG, Matarraz S, Ogata K, Oelschlaegel U, Orfao A, Psarra K, Subirá D, Wells DA, Béné MC, Della Porta MG, Burbury K, Bellos F, van der Velden VHJ, Westers TM, Saft L, Ireland R. Clinical application of flow cytometry in patients with unexplained cytopenia and suspected myelodysplastic syndrome: A report of the European LeukemiaNet International MDS-Flow Cytometry Working Group. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2023; 104:77-86. [PMID: 34897979 DOI: 10.1002/cyto.b.22044] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/12/2021] [Accepted: 11/29/2021] [Indexed: 02/06/2023]
Abstract
This article discusses the rationale for inclusion of flow cytometry (FCM) in the diagnostic investigation and evaluation of cytopenias of uncertain origin and suspected myelodysplastic syndromes (MDS) by the European LeukemiaNet international MDS Flow Working Group (ELN iMDS Flow WG). The WHO 2016 classification recognizes that FCM contributes to the diagnosis of MDS and may be useful for prognostication, prediction, and evaluation of response to therapy and follow-up of MDS patients.
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Affiliation(s)
- Arjan A van de Loosdrecht
- Department of Hematology, Amsterdam UMC, location VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | | | - Anna Porwit
- Department of Clinical Sciences, Division of Oncology and Pathology, Faculty of Medicine, Lund University, Lund, Sweden
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology and Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | | | - Eline Cremers
- Department of Internal Medicine, Division of Hematology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Canan Alhan
- Department of Hematology, Amsterdam UMC, location VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Carolien Duetz
- Department of Hematology, Amsterdam UMC, location VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Alan Dunlop
- Department of Haemato-Oncology, Royal Marsden Hospital, London, UK
| | - Willemijn Hobo
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frank Preijers
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Orianne Wagner-Ballon
- Department of Hematology and Immunology, Assistance Publique-Hôpitaux de Paris, University Hospital Henri Mondor, Créteil, France
- Université Paris-Est Créteil, Inserm U955, Créteil, France
| | - Nicolas Chapuis
- Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Centre-Université de Paris, Paris, France
- Institut Cochin, Université de Paris, INSERM U1016, CNRS UMR 8104, Paris, France
| | - Michaela Fontenay
- Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Centre-Université de Paris, Paris, France
- Institut Cochin, Université de Paris, INSERM U1016, CNRS UMR 8104, Paris, France
| | - Peter Bettelheim
- Department of Hematology, Ordensklinikum Linz, Elisabethinen, Linz, Austria
| | | | - Patricia Font
- Department of Hematology, Hospital General Universitario Gregorio Marañon - IiSGM, Madrid, Spain
| | - Ulrika Johansson
- Laboratory Medicine, SI-HMDS, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Jeroen G Te Marvelde
- Laboratory Medical Immunology, Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sergio Matarraz
- Cancer Research Center (CIC/IBMCC-USAL/CSIC), Department of Medicine and Cytometry Service, University of Salamanca, Institute for Biomedical Research of Salamanca (IBSAL) and CIBERONC, Salamanca, Spain
| | - Kiyoyuki Ogata
- Metropolitan Research and Treatment Centre for Blood Disorders (MRTC Japan), Tokyo, Japan
| | - Uta Oelschlaegel
- Department of Internal Medicine, University Hospital Carl-Gustav-Carus TU Dresden, Dresden, Germany
| | - Alberto Orfao
- Cancer Research Center (CIC/IBMCC-USAL/CSIC), Department of Medicine and Cytometry Service, University of Salamanca, Institute for Biomedical Research of Salamanca (IBSAL) and CIBERONC, Salamanca, Spain
| | - Katherina Psarra
- Department of Immunology - Histocompatibility, Evangelismos Hospital, Athens, Greece
| | - Dolores Subirá
- Department of Hematology, Flow Cytometry Unit, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | | | - Marie C Béné
- Hematology Biology, Nantes University Hospital and CRCINA, Nantes, France
| | - Matteo G Della Porta
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Kate Burbury
- Department of Haematology, Peter MacCallum Cancer Centre, and University of Melbourne, Melbourne, Australia
| | | | - Vincent H J van der Velden
- Laboratory Medical Immunology, Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Theresia M Westers
- Department of Hematology, Amsterdam UMC, location VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Leonie Saft
- Department of Clinical Pathology, Division of Hematopathology, Karolinska University Hospital and Institute, Stockholm, Sweden
| | - Robin Ireland
- Department of Haematology and SE-HMDS, King's College Hospital NHS Foundation Trust, London, UK
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Morita Y, Nannya Y, Ichikawa M, Hanamoto H, Shibayama H, Maeda Y, Hata T, Miyamoto T, Kawabata H, Takeuchi K, Tanaka H, Kishimoto J, Miyano S, Matsumura I, Ogawa S, Akashi K, Kanakura Y, Mitani K. ASXL1 mutations with serum EPO levels predict poor response to darbepoetin alfa in lower-risk MDS: W-JHS MDS01 trial. Int J Hematol 2022; 116:659-668. [PMID: 35821550 PMCID: PMC9588475 DOI: 10.1007/s12185-022-03414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/25/2022]
Abstract
Darbepoetin alfa (DA) is used to treat anemia in lower-risk (IPSS low or int-1) myelodysplastic syndromes (MDS). However, whether mutations can predict the effectiveness of DA has not been examined. The present study aimed to determine predictive gene mutations. The primary endpoint was a correlation between the presence of highly frequent (≥ 10%) mutations and hematological improvement-erythroid according to IWG criteria 2006 by DA (240 μg/week) until week 16. The study included 79 patients (age 29–90, median 77.0 years; 52 [65.8%] male). Frequently (≥ 10%) mutated genes were SF3B1 (24 cases, 30.4%), TET2 (20, 25.3%), SRSF2 (10, 12.7%), ASXL1 (9, 11.4%), and DNMT3A (8, 10.1%). Overall response rate to DA was 70.9%. Multivariable analysis including baseline erythropoietin levels and red blood cell transfusion volumes as variables revealed that erythropoietin levels and mutations of ASXL1 gene were significantly associated with worse response (odds ratio 0.146, 95% confidence interval 0.042–0.503; p = 0.0023, odds ratio 0.175, 95% confidence interval 0.033–0.928; p = 0.0406, respectively). This study indicated that anemic patients who have higher erythropoietin levels and harbor ASXL1 gene mutations may respond poorly to DA. Alternative strategies are needed for the treatment of anemia in this population. Trial registration number and date of registration: UMIN000022185 and 09/05/2016.
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Affiliation(s)
- Yasuyoshi Morita
- Divison of Hematology and Rheumatology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan.,Division of Hematopoietic Disease Control, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Motoshi Ichikawa
- Department of Hematology and Oncology, Dokkyo Medical University, 880, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Hitoshi Hanamoto
- Department of Hematology, Faculty of Medicine, Nara Hospital Kindai University, Nara, Japan
| | - Hirohiko Shibayama
- Department of Hematology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Hiroshi Kawabata
- Department of Hematology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Kazuto Takeuchi
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Hiroko Tanaka
- Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Junji Kishimoto
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Satoru Miyano
- M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Itaru Matsumura
- Divison of Hematology and Rheumatology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan.,Institute for the Advanced Study of Human Biology (WPI-ASHBi), Department of Medicine, Kyoto University, Kyoto, Japan.,Center for Hematology and Regenerative Medicine, Karolinska Institute, Stockholm, Sweden
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Yuzuru Kanakura
- Department of Hematology and Oncology, Graduate School of Medicine, Osaka University, Osaka, Japan.,Sumitomo Hospital, Osaka, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, 880, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan.
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7
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Rosenberg CA, Bill M, Rodrigues MA, Hauerslev M, Kerndrup GB, Hokland P, Ludvigsen M. Exploring dyserythropoiesis in patients with myelodysplastic syndrome by imaging flow cytometry and machine-learning assisted morphometrics. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:554-567. [PMID: 33285035 DOI: 10.1002/cyto.b.21975] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/19/2020] [Accepted: 11/19/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The hallmark of myelodysplastic syndrome (MDS) remains dysplasia in the bone marrow (BM). However, diagnosing MDS may be challenging and subject to inter-observer variability. Thus, there is an unmet need for novel objective, standardized and reproducible methods for evaluating dysplasia. Imaging flow cytometry (IFC) offers combined analyses of phenotypic and image-based morphometric parameters, for example, cell size and nuclearity. Hence, we hypothesized IFC to be a useful tool in MDS diagnostics. METHODS Using a different-from-normal approach, we investigated dyserythropoiesis by quantifying morphometric features in a median of 5953 erythroblasts (range: 489-68,503) from 14 MDS patients, 11 healthy donors, 6 non-MDS controls with increased erythropoiesis, and 6 patients with cytopenia. RESULTS First, we morphometrically confirmed normal erythroid maturation, as immunophenotypically defined erythroid precursors could be sequenced by significantly decreasing cell-, nuclear- and cytoplasm area. In MDS samples, we demonstrated cell size enlargement and increased fractions of macronormoblasts in late-stage erythroblasts (both p < .0001). Interestingly, cytopenic controls with high-risk mutational patterns displayed highly aberrant cell size morphometrics. Furthermore, assisted by machine learning algorithms, we reliably identified and enumerated true binucleated erythroblasts at a significantly higher frequency in two out of three erythroblast maturation stages in MDS patients compared to normal BM (both p = .0001). CONCLUSION We demonstrate proof-of-concept results of the applicability of automated IFC-based techniques to study and quantify morphometric changes in dyserythropoietic BM cells. We propose that IFC holds great promise as a powerful and objective tool in the complex setting of MDS diagnostics with the potential for minimizing inter-observer variability.
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Affiliation(s)
| | - Marie Bill
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Mathias Hauerslev
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | - Gitte B Kerndrup
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Hokland
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Maja Ludvigsen
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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8
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Berta Mercedes MF, Isaac MR, Claudia LP, Fernando MM, Luis GA, José Antonio GV. Correlation of morphological and flow cytometric findings in the diagnosis of transient red cell aplasia due to parvovirus B19 infection. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:296-298. [PMID: 33052605 DOI: 10.1002/cyto.b.21964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 09/17/2020] [Accepted: 09/28/2020] [Indexed: 11/07/2022]
Affiliation(s)
| | - Martin Rubio Isaac
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Getafe, Madrid, Spain
| | - López Prieto Claudia
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Getafe, Madrid, Spain
| | - Martín Moro Fernando
- Servicio de Hematología y Hemoterapia, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - García Alonso Luis
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Getafe, Madrid, Spain
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9
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Violidaki D, Axler O, Jafari K, Bild F, Nilsson L, Mazur J, Ehinger M, Porwit A. Analysis of erythroid maturation in the nonlysed bone marrow with help of radar plots facilitates detection of flow cytometric aberrations in myelodysplastic syndromes. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 98:399-411. [DOI: 10.1002/cyto.b.21931] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 05/12/2020] [Accepted: 05/27/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Despoina Violidaki
- Department of Clinical Genetics and Pathology Skåne University Hospital Lund Sweden
- Department of Clinical Sciences Oncology and Pathology, Lund University Lund Sweden
| | - Olof Axler
- Department of Clinical Genetics and Pathology Skåne University Hospital Lund Sweden
| | - Katayoon Jafari
- Department of Pathology University of Saskatchewan, Royal University Hospital Saskatoon Saskatchewan Canada
| | - Filippa Bild
- Department of Clinical Genetics and Pathology Skåne University Hospital Lund Sweden
| | - Lars Nilsson
- Department of Hematology, Oncology and Radiation Physics Skåne University Hospital Lund Sweden
| | - Joanna Mazur
- Department of Humanization of Medicine and Sexology Collegium Medicum University of Zielona Gora Zielona Gora Poland
| | - Mats Ehinger
- Department of Clinical Genetics and Pathology Skåne University Hospital Lund Sweden
- Department of Clinical Sciences Oncology and Pathology, Lund University Lund Sweden
| | - Anna Porwit
- Department of Clinical Genetics and Pathology Skåne University Hospital Lund Sweden
- Department of Clinical Sciences Oncology and Pathology, Lund University Lund Sweden
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10
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Orfao A. Issue Highlights - May 2019. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 96:177-180. [PMID: 31091004 DOI: 10.1002/cyto.b.21786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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11
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Nuclear Inositides and Inositide-Dependent Signaling Pathways in Myelodysplastic Syndromes. Cells 2020; 9:cells9030697. [PMID: 32178280 PMCID: PMC7140618 DOI: 10.3390/cells9030697] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/04/2020] [Accepted: 03/11/2020] [Indexed: 12/21/2022] Open
Abstract
Myelodysplastic syndromes (MDS) are a heterogeneous group of hematological malignancies characterized by peripheral blood cytopenia and abnormal myeloproliferation, as well as a variable risk of evolution into acute myeloid leukemia (AML). The nucleus is a highly organized organelle with several distinct domains where nuclear inositides localize to mediate essential cellular events. Nuclear inositides play a critical role in the modulation of erythropoiesis or myelopoiesis. Here, we briefly review the nuclear structure, the localization of inositides and their metabolic enzymes in subnuclear compartments, and the molecular aspects of nuclear inositides in MDS.
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