Association between phenotypic features of blasts and the blast percentage in bone marrow of patients with myelodysplastic syndromes

Ogata, Kíyoyuki; Satoh, Chikako; Hyodo, Hideya; Tamura, Hideto; Dan, Kazuo; Yoshida, Yataro

doi:10.1016/j.leukres.2004.03.014

Cited by 13 publications

(19 citation statements)

References 12 publications

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“…9,11,17,31 In accordance with previous reports, the frequency of lineage infidelity marker expression on immature myeloid blasts was associated with an increase in the percentage of myeloid blasts and also with more advanced stages of the disease, including RCMD with or without RS, reflecting probably a more leukemic phenotype. 32 This supports the data from Malcovati et al, in which a significant decrease in overall survival and leukemiafree survival is noted from RA with or without RS toward RCMD with or without RS. 17 Prospective studies are ongoing to define which or which combination of lineage infidelity markers may have prognostic impact.…”

Section: Discussionsupporting

confidence: 91%

Identification of distinct prognostic subgroups in low- and intermediate-1–risk myelodysplastic syndromes by flow cytometry

Loosdrecht

Westers

Westra

et al. 2008

Blood

209

248

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The World Health Organization (WHO) classification contributes to refined classification and prognostication of myelodysplastic syndromes (MDSs). Flow cytometry might add significantly to diagnostic and prognostic criteria. Our analysis of bone marrow samples from 50 patients with MDS showed aberrant expression of differentiation antigens in the myelomonocytic lineage. This also accounted for refractory anemia (RA) with or without ringed sideroblasts (RS), indicating multilineage dysplasia. In 38% of patients, CD34 ؉ myeloid blasts expressed CD5, CD7, or CD56. Flow cytometry data were translated into a numerical MDS flow-score. Flow-scores increased significantly from RA with or without RS, refractory cytopenia with multilineage dysplasia (RCMD) with or without RS up to refractory anemia with excess of blasts-1 (RAEB-1) and RAEB-2. No significant differences were observed between WHO cytogenetic subgroups. Flow-scores were highly heterogeneous within International Prognostic Scoring System (IPSS) subgroups. Patients in progression to advanced MDS or acute myeloid leukemia had a significantly higher flow-score compared with non-transfusion-dependent patients. In 60% of patients with transfusion dependency or progressive disease, myeloid blasts expressed CD7 or CD56, in contrast to only 9% of non-transfusiondependent patients. Moreover, all patients with pure RA with or without RS with aberrant myeloid blasts showed an adverse clinical course. In conclusion, flow cytometry in MDS identified aberrancies in the myelomonocytic lineage not otherwise determined by cytomorphology. In addition, flow cytometry identified patients at risk for transfusion dependency and/or progressive disease independent of known risk groups, which might have impact on treatment decisions and the prognostic scoring system in the near future.

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Section: Discussionsupporting

confidence: 91%

Identification of distinct prognostic subgroups in low- and intermediate-1–risk myelodysplastic syndromes by flow cytometry

Loosdrecht

Westers

Westra

et al. 2008

Blood

209

248

View full text Add to dashboard Cite

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“…However, the challenge to more definitively determine individual patient prognosis and thus their appropriate treatment remains, especially within the IPSS Int-1 and Int-2 subgroups. Several variables have recently been studied with the intent to further refine the IPSS (lactic dehydrogenase, immunophenotyping, subgrouping of cytogenetic abnormalities, number of RBC transfusions) [8][9][10][11][12][13][14][15][16][17][18]. To examine the basic data which led to the IPSS classification in more detail, in our retrospective database analysis of primary patients with MDS who had not been treated with disease-altering therapy, we focused on assessing the depth of cytopenias as potential variables that could add further prognostic value to the IPSS.…”

Section: Discussionmentioning

confidence: 99%

“…However, further refinement is needed for predicting the prognosis of individual patients with MDS, particularly for those in the intermediate-risk groups. More recently, a number of new variables have been proposed that could potentially refine the current IPSS, including lactic dehydrogenase [8][9][10][11], immunophenotyping [12][13][14], further subgrouping of cytogenetic abnormalities [15,16], number of red blood cell (RBC) transfusions [17,18], and depth of neutropenia [19] and thrombocytopenia [20]. Although the number of cytopenias is included as a variable within the IPSS, the depth of cytopenias has not been studied as an independent prognosticator of overall survival (OS) and time to acute myeloid leukemia (AML) evolution in patients with MDS.…”

Section: Introductionmentioning

confidence: 99%

International MDS risk analysis workshop (IMRAW)/IPSS reanalyzed: Impact of cytopenias on clinical outcomes in myelodysplastic syndromes

2008

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The International Prognostic Scoring System (IPSS) was created for evaluating clinical outcomes of patients with myelodysplastic syndromes (MDS). We evaluated the depth of cytopenias to determine whether this parameter could further refine the prognostic ability of the IPSS. Correlation was determined between the depth of cytopenias in 816 patients from the International MDS Risk Analysis Workshop database and patients' clinical features. Univariate analyses of hemoglobin (Hb), absolute neutrophil count, and platelet depth levels were assessed relative to the IPSS risk groups, refined French-American-British categories, cytogenetic groups, bone marrow blast percentage (%), age groups, overall survival (OS), and time to evolution of acute myeloid leukemia (AML). Multivariate analysis of different cytopenic levels was performed to determine whether depth of cytopenias was prognostically additive to the IPSS. All cytopenic categories had statistically significant rank correlations with IPSS, bone marrow blast %, and refined French-American-British categories. In multivariate analysis, Hb levels had additive prognostic value to the IPSS for evaluation of OS, but not time to AML, with greatest prognostic value in Intermediate-1 and Intermediate-2 categories. In contrast, platelet or absolute neutrophil count levels alone or in combination lacked additive prognostic value to the IPSS regarding OS or time to AML evolution. The depth of Hb level per se at the time of diagnosis has additive predictive value to the IPSS for OS in the intermediate-risk groups. This information should prove useful for aiding therapeutic decision-making, prognostic classification, and designing clinical trials for patients with MDS. Am. J. Hematol. 83:765-770, 2008. V

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“…The first consensual agreement concerning this item was that at present only bone marrow aspirates are suitable samples for the immunophenotypic study of MDS. Consensus was reached on that the neutrophil and monocytic lineages are the two main lineages where immunophenotyping might provide robust information for the discrimination among normal hematopoiesis, myelodysplasia, and leukemia (16)(17)(18). Accordingly, an antibody panel for assessing maturation within these cell populations was agreed upon, as summarized in Table 5.…”

Section: Panels Of Combinations Of Monoclonal Antibodiesmentioning

confidence: 99%

Report on the second Latin American consensus conference for flow cytometric immunophenotyping of hematological malignancies

Ruı́z-Argüelles

Rivadeneyra-Espínoza

Duque

et al. 2005

Cytometry Part B Clinical

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On May 3 and 4, 2005, the Second Latin American Consensus Conference for the Immunophenotyping of Hematological Malignancies took place in Queretaro, México, with representatives from 10 countries of the region and two external consultants. This document summarizes the major conclusions for which consensus were achieved. Major differences regarding the recommendations from the first conference, which took place 9 years ago, concern the medical indications and the antibody panels for immunophenotyping. The aim of disseminating these guidelines to the international community is based on the potential interest for other countries with similar socioeconomic conditions. © 2005 Wiley‐Liss, Inc.

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Association between phenotypic features of blasts and the blast percentage in bone marrow of patients with myelodysplastic syndromes

Cited by 13 publications

References 12 publications

Identification of distinct prognostic subgroups in low- and intermediate-1–risk myelodysplastic syndromes by flow cytometry

Identification of distinct prognostic subgroups in low- and intermediate-1–risk myelodysplastic syndromes by flow cytometry

International MDS risk analysis workshop (IMRAW)/IPSS reanalyzed: Impact of cytopenias on clinical outcomes in myelodysplastic syndromes

Report on the second Latin American consensus conference for flow cytometric immunophenotyping of hematological malignancies

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