Cytometry Part B (Clinical Cytometry) 88B:207–209 (2015)
Brief Communication
Translating the MDS Flow Cytometric Score into Clinical Practice Michiel Heron,1* Elisabeth Dovern,2 Liesbeth E. Bakker-Jonges,1 Eduardus F.M. Posthuma,2 Rolf E. Brouwer,2 Frank Smedts,3 and Manou R. Batstra1 1
Medical Laboratories, Department of Immunology, Reinier de Graaf Groep, Delft, The Netherlands 2 Department of Hematology, Reinier de Graaf Groep, Delft, The Netherlands 3 Department of Pathology, Reinier de Graaf Groep, Delft, The Netherlands
Myelodysplastic syndromes (MDS) are classified by the WHO as myeloid neoplasms, and are characterized by cytopenia and dysplasia in one or more myeloid cell lines. Recently, a flow cytometric score (FCM-score) was published capable of discriminating low-grade MDS from non-clonal cytopenias (Della Porta et al., 2012). We tested the applicability of the FCM-score in a patient population from a large peripheral teaching hospital in The Netherlands. The evaluation of the proposed FCM score in low-grade MDS showed a high sensitivity and specificity, and clinically significant positive and negative likelihood ratios. The use of CD10 and CD19 positivity to identify progenitor B-cell blasts provided a specific and precize method to separate progenitor B-cell blasts from myeloid blasts within the CD341/low CD451 population and may be more convenient compared to the published method using low SSC and CD45 expression. This study confirms the value of C 2014 International Clinical Cytometry Society utilizing the FCM-score in our patient population. V Key terms: myelodysplastic syndrome; flow cytometry; immunophenotype
How to cite this article: Heron M, Dovern E, Bakker-Jonges L.E, Posthuma E.F.M Brouwer R.E, Smedts F, and Batstra M.R. Translating the MDS Flow Cytometric Score into Clinical Practice. Cytometry Part B 2015; 88B: 207–209.
Myelodysplastic syndromes (MDS) are classified by the WHO as myeloid neoplasms, and are characterized by cytopenia and dysplasia in one or more myeloid cell lines (1). They are the result of ineffective hematopoiesis that leads to an increased risk of developing acute myeloid leukemia. When patients lack specific diagnostic markers, such as clonal cytogenetic abnormalities and/or ringsideroblasts, the diagnosis MDS is not always straightforward. Recently, a flow cytometric score (FCM-score) was published capable of discriminating low-grade MDS from nonclonal cytopenias (2). We tested the applicability of the FCM-score in a patient population from a large peripheral teaching hospital in The Netherlands. The FCM algorithm as proposed by Della Porte et al. (2) measures four cardinal parameters (cutoff): CD341 myeloid blast cells (2%) and CD341 B-progenitorrelated cluster size (5%), lymphocyte/myeloid blast cell CD45 mean fluorescence intensity (MFI) ratio (4 or 7.5) and granulocyte/lymphocyte side scatter peak channel ratio (
Brief Communication
Translating the MDS Flow Cytometric Score into Clinical Practice Michiel Heron,1* Elisabeth Dovern,2 Liesbeth E. Bakker-Jonges,1 Eduardus F.M. Posthuma,2 Rolf E. Brouwer,2 Frank Smedts,3 and Manou R. Batstra1 1
Medical Laboratories, Department of Immunology, Reinier de Graaf Groep, Delft, The Netherlands 2 Department of Hematology, Reinier de Graaf Groep, Delft, The Netherlands 3 Department of Pathology, Reinier de Graaf Groep, Delft, The Netherlands
Myelodysplastic syndromes (MDS) are classified by the WHO as myeloid neoplasms, and are characterized by cytopenia and dysplasia in one or more myeloid cell lines. Recently, a flow cytometric score (FCM-score) was published capable of discriminating low-grade MDS from non-clonal cytopenias (Della Porta et al., 2012). We tested the applicability of the FCM-score in a patient population from a large peripheral teaching hospital in The Netherlands. The evaluation of the proposed FCM score in low-grade MDS showed a high sensitivity and specificity, and clinically significant positive and negative likelihood ratios. The use of CD10 and CD19 positivity to identify progenitor B-cell blasts provided a specific and precize method to separate progenitor B-cell blasts from myeloid blasts within the CD341/low CD451 population and may be more convenient compared to the published method using low SSC and CD45 expression. This study confirms the value of C 2014 International Clinical Cytometry Society utilizing the FCM-score in our patient population. V Key terms: myelodysplastic syndrome; flow cytometry; immunophenotype
How to cite this article: Heron M, Dovern E, Bakker-Jonges L.E, Posthuma E.F.M Brouwer R.E, Smedts F, and Batstra M.R. Translating the MDS Flow Cytometric Score into Clinical Practice. Cytometry Part B 2015; 88B: 207–209.
Myelodysplastic syndromes (MDS) are classified by the WHO as myeloid neoplasms, and are characterized by cytopenia and dysplasia in one or more myeloid cell lines (1). They are the result of ineffective hematopoiesis that leads to an increased risk of developing acute myeloid leukemia. When patients lack specific diagnostic markers, such as clonal cytogenetic abnormalities and/or ringsideroblasts, the diagnosis MDS is not always straightforward. Recently, a flow cytometric score (FCM-score) was published capable of discriminating low-grade MDS from nonclonal cytopenias (2). We tested the applicability of the FCM-score in a patient population from a large peripheral teaching hospital in The Netherlands. The FCM algorithm as proposed by Della Porte et al. (2) measures four cardinal parameters (cutoff): CD341 myeloid blast cells (2%) and CD341 B-progenitorrelated cluster size (5%), lymphocyte/myeloid blast cell CD45 mean fluorescence intensity (MFI) ratio (4 or 7.5) and granulocyte/lymphocyte side scatter peak channel ratio (
