Phenotypic landscape of granulocytes and monocytes by multiparametric flow cytometry: A prospective study of a 1‐tube panel strategy for diagnosis and prognosis of patients with MDS

Abstract

Background: Multiparametric flow cytometry (MFC) was recently reported to be a helpful additional tool in the diagnosis of myelodysplastic syndromes (MDS). However, numerous aberrancies have been reported that makes their evaluation difficult as part of a routine diagnosis.Methods: Here, we validated a 1-tube panel for the evaluation of granulocytic and monocytic maturation by MFC and correlated our findings with diagnosis and prognosis of MDS. A total of 251 samples with MDS suspicion were prospectively analyzed and compared to an internal reference database leading to the calculation of the Diff score.Results: The associated specificity and sensitivity values of this scoring system were 92.1% and 60.4% in a first learning cohort and 96.7% and 65.2% in a second independent validation cohort. The combination of the Diff score with the concomitantly calculated Ogata score increased the sensitivity to 74.2% and 78.3% in the learning and validation cohorts, respectively. Finally, a normal Diff score in MDS patients was associated with a significant prolonged progression-free survival.Conclusions: Taken together, the present data indicate that our strategy is a sensitive and specific MFC tool for the diagnosis of MDS-related cytopenia(s) which could be also useful for predicting evolution of these diseases. K E Y W O R D S diagnosis, disease progression, maturation pathways, MDS, multiparametric flow cytometry

MRD abnormal expression predict poor outcomes for refractory or relapsed acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation

“…Previous studies have shown immunophenotype abnormalities are useful for MRD detection and quantification with the aim of providing prognostic information. 34 , 35 Chang et al 36 found that, in normal karyotype AML, CD7 was expressed in 37% of patients, and CD7 was associated with shorter DFS. In our study, 48 patients expressed CD7 in 143 not in MRD‐negative patients pre‐HCT (34%), and survival analysis shown CD7+ patients associated with the worst prognosis compared with CD56+, HLA‐DR‐, and CD38‐ patients in the MRD 1+ group (Figure A1 in Appendix 1 ).…”

“…34,35 Chang et al36 found that, in Univariate Analyses for DFS, OS, Relapse and NRM in MRD+ and NR patients (p)…”

ISSUE HIGHLIGHTS ‐ May 2020

“…A recent review by Duetz and colleagues (5) nicely overviews developments and possible future directions of these studies. In this issue, Barreau et al (6) validate a one tube, 10 antibody panel to study maturing granulocyte and monocyte populations in bone marrow samples from 251 patients. A number of panels and markers have been proposed to MDS evaluation, and as shown by Font et al (7), standardization among laboratories is accomplished by substantial effort.…”

Issue Highlights – September 2020

“…Myelodysplastic Syndrome (MDS) is usually diagnosed by morphology but multicolor flow cytometry has been well established as a helpful tool. Most recently recommendations have been put forth stating that an abnormal flow cytometric phenotype should be considered as a criterion in the diagnosis of patients with suspected MDS (7,8). The use of flow cytometry for the diagnosis of MDS is currently limited to expert laboratories because of the difficulty analyzing and quantifying the many phenotypic abnormalities associated with this heterogenous disease (8).…”

“…Most recently recommendations have been put forth stating that an abnormal flow cytometric phenotype should be considered as a criterion in the diagnosis of patients with suspected MDS (7,8). The use of flow cytometry for the diagnosis of MDS is currently limited to expert laboratories because of the difficulty analyzing and quantifying the many phenotypic abnormalities associated with this heterogenous disease (8). Anna Porwit and colleagues from Skåne and Lund University in Sweden and University of Saskatchewan in Canada describe an interesting new approach to examine erythroid maturation in patients with myelodysplastic syndrome.…”