Flowcytometry in myelodysplastic syndromes: Towards a new paradigm in diagnosis and prognostication?

Loosdrecht, Arjan A. van de; Westers, Theresia M.; Ossenkoppele, Gert J.

doi:10.1016/j.leukres.2007.07.008

Cited by 5 publications

(6 citation statements)

References 18 publications

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“…The original FCSS was modified to give additional weight to these marrows in order to reflect the importance of the presence of abnormal MyPC, which has been previously reported in other prognostic and diagnostic studies (13, 17–20). In this study, three cases were identified with less than 5% abnormal MyPC without myelomonocytic abnormalities and were given a modified FCSS of two including: one case with del(5q) and monosomy 7 having clearly abnormal MyPC present at 1.5% showing decreased CD45 and decreased CD13; a del(20q) case with MyPC present at 4.4% with reduced CD45; and a case of trisomy 8 with MyPC showing reduced CD45, dim CD7, and dim CD13.…”

Section: Resultsmentioning

confidence: 99%

Phenotypic abnormalities strongly reflect genotype in patients with unexplained cytopenias

Cutler¹,

Wells²,

Loosdrecht

et al. 2010

Cytometry Part B Clinical

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Section: Resultsmentioning

confidence: 99%

Phenotypic abnormalities strongly reflect genotype in patients with unexplained cytopenias

Cutler¹,

Wells²,

Loosdrecht

et al. 2010

Cytometry Part B Clinical

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“…Because of the extensive variability from patient to patient as well as the changes that occur over time for an individual patient, single specific antigenic changes are not sufficient to fully capture the extent of regulation loss. 13,20,22,23 The abnormalities seen are not just in the expression of single antigens but affect the relationships between multiple antigens. 13,[19][20][21] Panels of monoclonal antibodies must be integrated so researchers can focus on the steps of myeloid and monocyte development in which multiple gene products are co-regulated and thus note the loss of coordination of regulation of gene products at multiple steps during development.…”

Section: Phenotypic Changes In Neoplastic Bone Marrowmentioning

confidence: 99%

“…10 Other abnormalities can be seen in physical changes of cell size (detected by forward light scatter) and granularity (identified by right angle light scatter or side scatter, where the included granules in myeloid cells act like tiny mirrors reflecting light into the detector). [19][20][21][22] Phenotypic abnormalities on the myeloblasts have been studied on total CD34 positive cells, 17 immature or maturing CD34 positive cells, 24 or the entire maturing myeloblast population independent of CD34 expression. 19,21,25 Flow cytometry analysis (focusing on normal/ abnormal blasts, myeloid and monocyte development) to detect phenotypic abnormalities (phenotypic dysplasia) can be complementary to morphologic analysis of bone marrow.…”

Section: Phenotypic Changes In Neoplastic Bone Marrowmentioning

confidence: 99%

The Role of Flow Cytometry in Myelodysplastic Syndromes

Loken¹,

Wells²

2008

J Natl Compr Canc Netw

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Flow cytometry quantifies the gene product expression on hematopoietic cells, permitting the identification of all cells within a bone marrow aspirate and classifying them according to lineage and maturational stage. The relationships in the expression of multiple markers on myeloblasts, maturing monocytes, and myeloid cells suggests that development of these cells is a stepwise process in which genes are not only turned on or off, but are up- and down-regulated at the junctions between stages. In neoplastic processes, a loss of coordination of these steps is seen, resulting in the abnormal relationships identified by flow cytometry. In myelodysplastic syndromes, the abnormal patterns can be identified on both the immature myeloblasts and maturing myeloid cells and monocytes. The detection of these abnormalities is useful in diagnosing myelodysplasia but requires a detailed understanding of the expression of these gene products to discriminate neoplastic transformation from a stressed marrow. Although the patterns of antigen expression for normal hematopoiesis are precisely defined, each patient with a neoplastic transformation has a unique repertoire of abnormalities that may evolve as the disease progresses. Therefore, scoring systems, in which the abnormalities are counted, provide a means for determining the extent of dysregulation at all the maturational steps, thereby determining a "distance from normal" for a patient at a specific time in the disease course. This is useful, not only to facilitate diagnosis, but to provide prognostic information that may be complementary to the conventional classification schemes and scoring systems.

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“…However, these techniques are not standardized and may be less specific for MDS. Another approach is to determine cell surface antigen patterns in CD34 + blast cells and more mature myeloid cells by flow cyometry [21–24]. Likewise, flow cytometry is a powerful tool for assessment of aberrant marker expression in CD34 + blasts [21–24].…”

Section: Co‐criteria For the Definition Of Mdsmentioning

confidence: 99%

“…Again, results obtained by this technique are not specific for MDS. However, flow cytometry and molecular studies are reliable and sensitive techniques that may help in reaching the conclusion that the patient is suffering from a monoclonal myeloid disorder resembling MDS [19–23]. In addition, using new techniques, it may also be possible to quantify the various bone marrow lineages in MDS by flow cytometry [25].…”

Section: Co‐criteria For the Definition Of Mdsmentioning

confidence: 99%

Minimal diagnostic criteria for myelodysplastic syndromes and separation from ICUS and IDUS: update and open questions

Valent

Horny²

2009

Eur J Clin Investigation

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Although a classification for myelodysplastic syndromes (MDS) has been proposed by several working groups and by the World Health Organization (WHO), with criteria useful to discriminate between disease variants, the important issue of minimal diagnostic criteria of MDS has only recently been addressed. In the current article, proposed minimal diagnostic criteria for MDS are discussed together with two conditions that do not meet these criteria, although cytopenia or dysplasia is present. These two conditions, idiopathic cytopenia of unknown significance and idiopathic dysplasia of unknown significance should be kept in mind as a provisional (potential) diagnosis in patients with suspected MDS. Both conditions can progress to frank MDS over time. Therefore, once diagnosed, these patients should have a haematological follow-up. The diagnosis MDS, on the other hand, needs to be based on robust criteria and exclusion of all other causes of cytopenia and dysplasia, which requires detailed and sometimes extensive investigations, including a bone marrow biopsy, cytogenetic analyses, molecular studies and flow cytometry.

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Flowcytometry in myelodysplastic syndromes: Towards a new paradigm in diagnosis and prognostication?

Cited by 5 publications

References 18 publications

Phenotypic abnormalities strongly reflect genotype in patients with unexplained cytopenias

Phenotypic abnormalities strongly reflect genotype in patients with unexplained cytopenias

The Role of Flow Cytometry in Myelodysplastic Syndromes

Minimal diagnostic criteria for myelodysplastic syndromes and separation from ICUS and IDUS: update and open questions

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