Flow cytometry “Ogata score” for the diagnosis of myelodysplastic syndromes in a real‐life setting. A Latin American experience

Abstract

Introduction Flow cytometry (FC) is a helpful tool for the diagnosis of myelodysplastic syndrome (MDS). Different FC score systems have been developed. The “Ogata score” is a simple diagnostic score that has been validated having a sensitivity of 69% and a specificity of 92% in low‐risk MDS. We aimed to study the feasibility and the utility of the “Ogata score” for the diagnosis of MDS among Latin America (LA) Laboratories. Methods This is a case and control study conducted in LA institutions members of Grupo Latinoamericano de Mielodisplasia (GLAM). A total of 146 MDS patients and 57 control patients were included. “Ogata score” was calculated. Results The sensitivity of “Ogata score” was 75.6% (95% CI, 66.8‐81.3), specificity was 91.2% (95% CI, 79.7‐96.7), PPV was 95.6% (95% CI, 88.5‐98.3), and NPV was 65.4% (95% CI, 49.1‐71.9). In low/intermediate‐1 IPSS patients group, the sensitivity was 70.1% (95% CI, 60.2‐78.2), specificity was 91.2% (CI‐95%, 79.7‐96.7), PPV was 94.2% (95% CI, 86.4‐97.8), and NPV was 62.1% (95% CI, 53.0‐78.7). In the group of patients “without MDS specific markers” (patients without ring sideroblasts, blast excess, or chromosomal abnormalities), the sensitivity was 66.7% (CI‐95%, 55.8‐76.0), specificity was 91.2% (95% CI, 79.7‐96.7), PPV was 92.3% (95% CI, 82.2‐97.1), and NPV was 63.5% (95% CI, 51.9‐73.5). Conclusions The diagnostic power found in this study was similar to the reported by Della‐Porta et al. Also in LA, the analysis was made in modern equipment with acquisition of at least 100 000 events which permits a good reproducibility of the results.

Comparison of five diagnostic flow cytometry scores in patients with myelodysplastic syndromes: Diagnostic power and prognostic impact

“…Thus, our results confirm the test performance described by Cremers and colleagues (Cremers et al, 2017). In line with the literature, Ogata-score, RED-score, and ELN-NEC also revealed a very high specificity (Della Porta et al, 2012;Grille Montauban et al, 2019;Mathis et al, 2013;Ogata et al, 2009;Westers et al, 2017). However, probably due to their focus on a single cell compartment (progenitors or NEC) sensitivity of these FCM-scores is lower.…”

Multiparameter flow cytometry in the evaluation of myelodysplasia: Analytical issues

“…MFC will complement the primary morphological evaluation, especially in borderline cases where immunophenotypic aberrations can support or exclude MDS diagnosis (as illustrated in a diagnostic algorithm presented in Figure 1 in . The previous iMDSflow recommendation that the four-parameter Ogata score (Ogata et al, 2009) may be used for a preliminary assessment of MFC dysplasia has been confirmed by several publications (Bardet et al, 2015;Dhingra et al, 2020;Grille Montauban et al, 2019;Kárai et al, 2017;Mannelli et al, 2019;Matzen et al, 2018;Muyldermans et al, 2019;. This score is based on the frequency of myeloid CD34 + myeloid progenitors (MP) (>2%), the fraction of B-cell precursors within CD34 + cells (<5%), abnormal CD45 expression on CD34 + blasts, and low granulocyte scatter (granulocyte/lymphocyte SSC ratio ≤6).…”

“…Multiple reports from various countries have confirmed the diagnostic value of iMDSFlow recommendations (Chauhan et al, 2021;Cremers et al, 2016;Cremers et al, 2017;Davydova et al, 2021;Grille Montauban et al, 2019;Majcherek et al, 2021;Takeuchi et al, 2020). However, results of a survey concerning current MFC practice in 229 laboratories around the world showed that although many laboratories used large numbers of markers in MFC workup of MDS (median: 20 ± 4.5), the compliance with iMDSflow recommendations was low, and proposed scoring systems were not widely applied (Grille Montauban et al, 2019;Jensen et al, 2019). With the hope of increasing the harmonization of MFC MDS diagnostics, the current paper presents a summary of the progress in this field and an update on consensus iMDSFlow guidelines for the assessment of significant anomalies in various bone marrow (BM) cell compartments for MFC features of dysplasia as a part of a special Issue of Clinical Cytometry B, focused on MFC applications in MDS and MDS/MPN (Kern et al, 2022;van der Velden et al, 2023;Wagner-Ballon et al, 2023;Westers et al, 2021;Westers et al, 2023).…”

“…MFC performed according to iMDSFlow has been recommended by ELN guidelines at diagnosis and following therapy of MDS patients (Malcovati et al, 2013) and by the MDS Consensus Group (Valent et al, 2017). Multiple reports from various countries have confirmed the diagnostic value of iMDSFlow recommendations (Chauhan et al, 2021;Cremers et al, 2016;Cremers et al, 2017;Davydova et al, 2021;Grille Montauban et al, 2019;Majcherek et al, 2021;Takeuchi et al, 2020). However, results of a survey concerning current MFC practice in 229 laboratories around the world showed that although many laboratories used large numbers of markers in MFC workup of MDS (median: 20 ± 4.5), the compliance with iMDSflow recommendations was low, and proposed scoring systems were not widely applied (Grille Montauban et al, 2019;Jensen et al, 2019).…”

O estudo dos precursores hematopoiéticos e subtipos de monócitos nas síndromes mielodisplásicas para a construção de um novo score prognóstico

“…Em primeiro lugar, confirmamos o valor prognóstico do aumento dos progenitores mielóides CD34 + e diminuição dos progenitores de células B, o que já foi descrito por nosso grupo (21,29,45) e também por outros (15,22,27,46,47).…”