Sindhu Cherian and Jonni Moore contributed equally to this work.
Peripheral blood MDS score: A new flow cytometric tool for the diagnosis of myelodysplastic syndromes†
Article first published online: 24 JAN 2005
Copyright © 2005 Wiley-Liss, Inc.
Cytometry Part B: Clinical Cytometry
Volume 64B, Issue 1, pages 9–17, March 2005
How to Cite
Cherian, S., Moore, J., Bantly, A., Vergilio, J.-A., Klein, P., Luger, S. and Bagg, A. (2005), Peripheral blood MDS score: A new flow cytometric tool for the diagnosis of myelodysplastic syndromes. Cytometry, 64B: 9–17. doi: 10.1002/cyto.b.20041
Portions of the data presented in this manuscript were presented at the 2003 Annual Clinical Cytometry Society meeting in Arlington, VA and at the 2003 annual meeting of the American Society of Hematology in San Diego, CA.
- Issue published online: 17 FEB 2005
- Article first published online: 24 JAN 2005
- Manuscript Accepted: 7 OCT 2004
- Manuscript Received: 29 MAR 2004
- National Institutes of Health. Grant Number: P30 CA16520
- Leukemia and Lymphoma Society of America. Grant Number: 7000-02
- myelodysplastic syndrome;
- flow cytometry;
- peripheral blood;
Myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic disorders diagnosed using morphologic and clinical findings supported by cytogenetics. Because abnormalities may be subtle, diagnosis using these approaches can be challenging. Flow cytometric (FCM) approaches have been described; however the value of bone marrow immunophenotyping in MDS remains unclear due to the variability in detected abnormalities. We sought to refine the FCM approach by using peripheral blood (PB) to create a clinically useful tool for the diagnosis of MDS.
PB from 15 patients with MDS was analyzed by multiparametric flow cytometry using an extensive panel of monoclonal antibodies. Patterns of neutrophil antigen expression were compared with those of normal controls (n = 16) to establish light scatter and/or immunophenotypic abnormalities that correlated with MDS. A scoring algorithm was developed and validated prospectively on a blinded patient set.
PB neutrophils from patients with MDS had lower side scatter and higher expression of CD66 and CD11a than did controls. Some MDS PB neutrophils demonstrated abnormal CD116 and CD10 expression. Because none of these abnormalities proved consistently diagnostic, we sought to increase the power of the assay by devising a scoring system to allow the association of multiple abnormalities and account for phenotypic variations. The PB MDS score differentiated patients with MDS from controls (P < 0.0001) in the test set. In a prospective validation, the PB MDS score successfully identified patients with MDS (sensitivity 73%, specificity 90%).
FCM analysis of side scatter and only four additional immunophenotypic parameters of PB neutrophils using the PB MDS score proved more sensitive than standard laboratory approaches and may provide an additional, more reliable diagnostic tool in the identification of MDS. © 2005 Wiley-Liss, Inc.