Translating the MDS flow cytometric score into clinical practice.
M. Heron1, E. Dovern2, L.E. Bakker-Jonges1, E.F.M. Posthuma2, R.E. Brouwer2, F. Smedts3, M.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
E-mail: [email protected]
Keywords: myelodysplastic syndrome, flow cytometry, immunophenotype
Author contribution: MH and ED designed and performed the study and/or analysed data. MH and ED wrote the manuscript. LEB, EFMP, REB, FS and MRB provided intellectual input and advice on study design and analysis.
Conflict of Interest Disclosure: The authors have no conflict of interest to declare.
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as an ‘Accepted Article’, doi: 10.1002/cytob.21208 This article is protected by copyright. All rights reserved.
Cytometry: Part B - Clinical Cytometry
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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 (Swerdlow et al, 2008). 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 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 flow cytometric algorithm as proposed by Della Porte et al measures four cardinal parameters (cut-off): CD34+ myeloid blast cells (≥2%) and CD34+ B-progenitor-related cluster size (≤5%), lymphocyte/myeloid blast cell CD45 MFI ratio (≤4 or ≥7.5) and granulocyte/lymphocyte side scatter peak channel ratio (
M. Heron1, E. Dovern2, L.E. Bakker-Jonges1, E.F.M. Posthuma2, R.E. Brouwer2, F. Smedts3, M.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
E-mail: [email protected]
Keywords: myelodysplastic syndrome, flow cytometry, immunophenotype
Author contribution: MH and ED designed and performed the study and/or analysed data. MH and ED wrote the manuscript. LEB, EFMP, REB, FS and MRB provided intellectual input and advice on study design and analysis.
Conflict of Interest Disclosure: The authors have no conflict of interest to declare.
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as an ‘Accepted Article’, doi: 10.1002/cytob.21208 This article is protected by copyright. All rights reserved.
Cytometry: Part B - Clinical Cytometry
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
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 (Swerdlow et al, 2008). 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 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 flow cytometric algorithm as proposed by Della Porte et al measures four cardinal parameters (cut-off): CD34+ myeloid blast cells (≥2%) and CD34+ B-progenitor-related cluster size (≤5%), lymphocyte/myeloid blast cell CD45 MFI ratio (≤4 or ≥7.5) and granulocyte/lymphocyte side scatter peak channel ratio (
