Clinical utility of multiparameter flow cytometry in the diagnosis of 1013 patients with suspected myelodysplastic syndrome

Abstract

BACKGROUND:The diagnosis and classification of myelodysplastic syndromes (MDS) is based on cytomorphology (CM) and cytogenetics (CG). Multiparameter flow cytometry (MFC) may add important diagnostic information. METHODS: To evaluate the potential role of MFC in the diagnostic setting of MDS, the authors analyzed the results from 1013 patients with suspected MDS by using CM, CG, and MFC in parallel. RESULTS: Concordance between CM and MFC was 82% for diagnostic results in 788 patients who had unequivocal CM results. An additional 225 patients had only minor dysplastic features identified by CM, including 51 patients (22.7%) who had clear evidence of MDS by MFC. Twelve patients who had no indication of MDS identified by CM had MDS-typical CG aberrations; in 6 of those patients (50%), MFC revealed MDS characteristics. In another 11 of 23 patients (47.8%) who had minor dysplastic features identified by CM and MDS-typical CG aberrations, MFC revealed MDS characteristics. The percentages of blasts determined by CM and by MFC were strongly correlated (P < .001). The frequency of aberrantly expressed antigens differed significantly between patients rated by CM as MDS (highest frequencies), suspected MDS, and no MDS (lowest frequencies). In various patients, MFC identified MDS-typical aberrant antigen expression in cell compartments that were not rated dysplastic by CM. The numbers of aberrantly expressed antigens were correlated with International Prognostic Scoring System scores and overall survival. CONCLUSIONS: The current analysis clearly demonstrated an increased diagnostic yield with MFC when added to CM and CG in patients with suspected MDS. Cancer

Myelodysplastic syndromes with a deletion 5q display a characteristic immunophenotypic profile suitable for diagnostics and response monitoring

“…4,5 We incorporated additional antigens, such as CD10, its decrease in granulopoiesis described as loss of synchronicity in relation to other maturation antigens, 7 CD36/CD71 expression on granulopoiesis, reported to correlate with IPSS, 8 and diminished (dim) expression CD71 on nucleated red cells (NRC), known as dyserythropoietic feature. 9,10 For gating strategy and cutoff values see the Online Supplementary Appendix and Online Supplementary Tables S1 and S2.…”

Reproducibility of the World Health Organization 2008 criteria for myelodysplastic syndromes

“…Although a good correlation between the percentage of blasts determined by morphological examination and percentage of CD34 + cells determined by flow cytometry is usually observed, blast enumeration by morphology is the gold-standard method. 4,22 The correct assignment of the percentage of blasts in peripheral blood is also crucial for a correct diagnosis and classification of patients. 23 In our study, we found a fair agreement in peripheral blood blast cell count.…”

Utilizing inherent fluorescence of therapeutics to analyze real-time uptake and multi-parametric effector kinetics

“…EHEC), malaria or even more pressing cancer [21][22][23]. Along these lines and as flow cytometry is already one of the key diagnostic methods in clinical workflows [24], the use of inherent compound fluorescence could be well extended to antibiotics in general. Many antibiotics are fluorescent [25] and would be fairly easy to screen bacterial, protozal or fungal patient samples for an abnormal reduction of intracellular fluorescence indicating a resistance mechanism aiding the process of precise and functional medication of a patient.…”