The Role of Flow Cytometric Immunophenotyping in Myelodysplastic Syndromes

Abstract

The myelodysplastic syndromes (MDSs) are a group of heterogeneous hematological disorders characterized by bilineage or trilineage dysplastic morphology, abnormal clonal populations, progressive bone marrow failure, and a high rate of transformation to acute myeloid leukemia. A combination of morphology, to detect multilineage dysplasia in the bone marrow and peripheral blood, and cytogenetics to detect characteristic clonal abnormalities, is used in establishing a diagnosis of MDS. Although diagnostic criteria are well established, a significant number of patients have blood and bone marrow findings that make diagnosis and classification difficult. Flow cytometric immunophenotyping is an accurate and highly sensitive method for quantitative and qualitative evaluation of hematopoietic cells in the different maturative compartments, and several groups have used flow cytometry in the study of MDSs. Findings of recent studies suggest that flow cytometry immunophenotyping might provide useful information in the diagnosis and the management of MDS patients.

Negative Effect of DNA Hypermethylation on the Outcome of Intensive Chemotherapy in Older Patients with High-Risk Myelodysplastic Syndromes and Acute Myeloid Leukemia following Myelodysplastic Syndrome

“…In fact, CD34 expression was a stronger predictor of response than WBC in the multivariate analysis. The novelty of this finding could probably be explained by the fact that immunophenotyping, although suggested as a predictive test for survival (30), rarely had been included as a pretreatment variable in clinical trials of high-risk MDS and MDS-AML. Previous studies have suggested a negative prognostic effect of surface expression of CD34 on survival in MDS and AML and also a relation between resistance to chemotherapy and CD34 expression (30 -33).…”

Determination of the proliferative fractions in differentiating hematopoietic cell lineages of normal bone marrow

“…With one-or two-fluorescence flow cytometry, the Ki-67 expression could only be determined for the total bone marrow cell population without being able to differentiate between the different cell lineages. Flow cytometric quantification of the cycling cells offers greater time-efficiency and reproducibility as compared to the microscopic examination of proliferative activity (12). This is controlled by the proliferative activity of progenitor cells, as well as by the number of grow-arrested cells and cells undergoing apoptosis (7,8).…”

Immunophenotype of myeloid granulocytes: a pilot study for distinguishing myelodysplastic syndrome and aplastic anemia by flow cytometry

“…It is extremely difficult to distinguish the hypoplastic myelodysplastic syndrome (h‐MDS) from AA. A combination of morphology, which detects multilineage dysplasia in the bone marrow and peripheral blood, and cytogenetics, which detects characteristic clonal abnormalities, is used in establishing a diagnosis of MDS (Pagnucco, Giambanco & Gervasi, 2006). However, the Myelodysplastic Syndrome Classification 2000 classifies refractory anemia (RA) without dysplasia as an MDS disorder (Bennett, 2000).…”