Background: Myelodysplastic syndromes (MDS) can present a challenge for clinicians. Multicolor flow cytometry (MFC) can aid in establishing a diagnosis. The aim of this study was to determine the optimal MFC approach for MDS.
Methods:The study included 102 MDS (39 low-grade MDS), 83 cytopenic patients without myeloid neoplastic disorders (control group), and 35 healthy donors. Bone marrow was analyzed using a six-color MFC. Analysis was conducted according to the "Ogata score," "Wells score," and the integrated flow cytometry (iFC) score.
Results:The respective sensitivity and specificity values were 77.5% and 90.4% for the Ogata score, 79.4% and 81.9% for the Wells score, and 87.3% and 87.6% for the iFC score. Specificity was not 100% due to deviations of MFC parameters in the control group. Patients with paroxysmal nocturnal hemoglobinuria (PNH) had higher levels of CD34 + CD7 + myeloid cells than donors. Aplastic anemia and PNH were characterized by a high proportion of CD56 + cells among CD34 + precursors and neutrophils. The proportion of MDS-related features increased with the progression of MDS. The highest number of CD34 + blasts was found in MDS with excess blasts.MDS with isolated del(5q) was characterized by a high proportion of CD34 + CD7 + cells and low granularity of neutrophils. In 39 low-grade MDS, the sensitivities were 53.8%, 61.5%, and 71.8% for Ogata score, Wells score, and iFC, respectively.
Conclusion:The results support iFC as a useful diagnostic tool in MDS.