Diagnostic Utility of Flow Cytometry in Myelodysplastic Syndromes

Abstract

Myelodysplastic syndromes (MDSs) are clonal disorders of hematopoiesis that exhibit heterogeneous clinical presentation and morphological findings, which complicates diagnosis, especially in early stages. Recently, refined definitions and standards in the diagnosis and treatment of MDS were proposed, but numerous questions remain. Multiparameter flow cytometry (MFC) is a helpful tool for the diagnostic workup of patients with suspected MDS, and various scores using MFC data have been developed. However, none of these methods have achieved the sensitivity that is required for a reassuring diagnosis in the absence of morphological abnormalities. One reason may be that each score evaluates one or two lineages without offering a broad view of the dysplastic process. The combination of two scores (e.g., Ogata and Red Score) improved the sensitivity from 50–60 to 88%, but the positive (PPV) and negative predictive values (NPV) must be improved. There are prominent differences between study groups when these scores are tested. Further research is needed to maximize the sensitivity of flow cytometric analysis in MDS. This review focuses on the application of flow cytometry for MDS diagnosis and discusses the advantages and limitations of different approaches.

Multicolor Flow Cytometry as a Diagnostic Tool in Myelodysplastic Syndromes

“…Более редкими аномалиями при МДС являются изменения в экспрессии антигенов CD33 и CD64, по явлениеHLA-DR,CD36иCD14нанейтрофилах. ПриМДСописываютвосновномснижениеэкспрессии CD33 и CD64 на гранулоцитах, однако следует относиться к этим признакам с осторожностью, так какихэкспрессиявариабельнаисвязанасгенетическимполиморфизмом.ЭкспрессияCD36повышается на нейтрофилах при апоптозе, а HLA-DR начинает экспрессироватьсяпослеприменениягранулоцитарногоколониестимулирующегоростовогофактора [14,15].ЭкспрессияCD14гранулоцитамивыявленаупа-циентовс5q-синдромом [35].…”

“…Необходимо оценивать множество параметров в основных компартментах КМ: зрелом миелоидном (нейтрофилы, моноциты), эритроидном ростках и компартменте раннихмиелоидныхиВ-клеточныхпредшественников. Эти цитометрические стратегии базируются наин терпретацииэкспрессииповерхностныхмаркеров кластеровдифференцировки(CD).Книмотносят по вышенную или сниженную по отношению креференснымзначенияминтенсивностьэкспрессии антигенов, асин хронную экспрессию антигенов иэкспрессиюлим фоидныхмаркеровнамиелобластныхклетках.Немало важноезначениеимеетподсчет доликлеток,составляющихопределенныеклеточные компартменты (особенно для миелоидных и В-клеточныхпредшественников) [15].…”

Usability of femoral head bone marrow to verify reference ranges for the assessment of myelodysplasia by flow cytometry

“…It requires an experienced and competent laboratory physician, and conclusions must be drawn with great caution. Some scientific groups investigated to which extent flow cytometry is applicable as an additional tool in an integrated diagnostic work‐up of MDS . Various flow cytometry techniques using multiple parameter scores have been developed and are increasingly promoted to aid diagnosing MDS …”

“…of MDS. [1][2][3][4] Various flow cytometry techniques using multiple parameter scores have been developed and are increasingly promoted to aid diagnosing MDS. [5][6][7] The implementation of the flow cytometry score (FCS) parameters to diagnose dysplasia is not straightforward.…”

OMIP‐049: Analysis of Human Myelopoiesis and Myeloid Neoplasms

“…The panel presented here, includes a framework that allows a broad overview of myelopoiesis from HSC through mature monocyte/macrophage populations, myeloid-derived suppressor cells (MDSC), and a broad spectrum of MDS/MPN disease subtypes(2, 12, 13-15) in a single 18-color panel (Table 2). The panel was constructed by first titrating the staining dilution of each antibody and calculating the optimal staining index (Supplemental Figures 1 and 2), and then in a step-wise manner building the panel based on category sets of parameters (Table 2), adding each category in turn (Supplemental Figure 3A-D).…”