Validation of a scoring system to establish the probability of myelodysplastic syndrome in patients with unexplained cytopenias or macrocytosis

Rauw, Jennifer; Wells, Richard A.; Chesney, Alden; Reis, Marciano D.; Zhang, Liying; Buckstein, Rena

doi:10.1016/j.leukres.2011.05.001

Cited by 25 publications

(16 citation statements)

References 14 publications

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“…Regarding RDW‐CV%, it has been suggested that increased RDW in MDS might reflect dyserythropoiesis, associated with deregulated hemoglobin synthesis and iron metabolism . Besides that, RDW (in peripheral blood) has been also proposed as an independent predictor of an MDS diagnosis . The significant value of RDW‐CV% as a discriminant hematological parameter was confirmed in our data.…”

Section: Discussionsupporting

confidence: 84%

“Bone marrow aspirate automated counts on hematology analyzers: formulating a scoring system based on hematology parameters, to discriminate reactive versus myelodysplastic syndrome‐related bone marrows”

Tsagarakis¹,

Paterakis²,

Papadhimitriou³

et al. 2019

Int J Lab Hematology

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Introduction Diagnosis of myelodysplastic syndromes (MDS) is usually challenging. In this context, we have attempted to employ data derived from automated analysis of bone marrow (BM) samples as an ancillary tool for the discrimination between reactive marrow and MDS. Methods A total of 101 BM anticoagulated samples referred for flow cytometry (FCM) analysis on the clinical suspicion of MDS had been previously counted in a Mindray BC‐6800 hematology analyzer (testing set). Among them, 22/101 randomly selected BM samples (comparison set) had been also simultaneously counted by an Advia 2120 and a CELL‐DYN Sapphire hematology analyzer. Selected parameters obtained by Mindray BC‐6800 were retrospectively evaluated with ROC and regression analysis in an attempt to formulate a discriminative scoring system (SS) for MDS. This system was further evaluated in the comparison set. Results The diagnosis of MDS was established in 37/101 patients assessed (“MDS” group). Three patients were diagnosed with myelodysplastic/myeloproliferative neoplasm (MDS/MPN), while 61 revealed a “reactive” bone marrow (“RBM” group). Statistical analysis revealed significant differences in Hb, RDW‐CV%, NRBC%, and RET% values between the “MDS” and the “RBM” group. Specific cutoff values were then indicated and employed for the formulation of a SS of high sensitivity (86.84%) and specificity (86.89%). The encouraging performance characteristics of the proposed SS were also confirmed in the BM comparison set. Conclusion Automated BM counts on hematology analyzers contributed to the formulation of a SS for the screening discrimination between reactive and MDS BM fluids, which seems to be applicable and informative, regardless of the analyzer used.

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Section: Discussionsupporting

confidence: 84%

“Bone marrow aspirate automated counts on hematology analyzers: formulating a scoring system based on hematology parameters, to discriminate reactive versus myelodysplastic syndrome‐related bone marrows”

Tsagarakis¹,

Paterakis²,

Papadhimitriou³

et al. 2019

Int J Lab Hematology

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“…In view of the fact that RDW level is indicative of abnormal red blood cell survival and that it correlates with the presence of inflammatory states [18,19], this parameter has been investigated as prognostic factor in hematological malignancies [20][21][22][23][24][25][26]. Some recent studies and a meta-analysis have demonstrated that RDW is a potent predictor of all-cause mortality, including cancer-related deaths [4,11].…”

Section: Discussionmentioning

confidence: 99%

The Association between Red Cell Distribution Width and Mortality in Pediatric Acute Lymphoblastic Leukemia

Rafsanjani¹,

Falahati²,

Kiumarsi³

et al. 2017

J Neoplasm

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“…It is often unexplained by low folate or vitamin B12 levels or abnormal thyroid and liver function tests [30]. It is more common in those older than 50 years of age and is associated with increased risk of myelodyspastic syndrome and worse outcomes after coronary interventions [29], [31], [32]. Differences of hematologic characteristics, including RBC size, have been studied in African Americans and European Americans and can only be partly explained by iron deficiency and the increased frequency of α-thalassemia deletion in African Americans [33].…”

Section: Discussionmentioning

confidence: 99%

Red Blood Cell Size Is Inversely Associated with Leukocyte Telomere Length in a Large Multi-Ethnic Population

Kozlitina

Garcia

2012

PLoS ONE

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Although mutations in the genes encoding either the protein or RNA component of telomerase have been found in patients with various blood disorders, the impact of telomere length on hematopoiesis is less well understood for subjects from the general population. Here we have measured telomere lengths of genomic DNA isolated from circulating leukocytes of 3157 subjects, ranging from 18 to 85 years of age, enrolled in a large multiethnic population based study, the Dallas Heart Study 2. Shorter telomere lengths are marginally associated with lower red blood cell counts in this cohort, but are significantly associated with larger mean red blood cell size (as measured by the MCV), increased red blood cell distribution width (RDW), higher hemoglobin levels and lower platelet counts, even after correction for age, gender and ethnicity (p-values of <0.0001, <0.0001, 0.0009 and 0.0016, respectively). In a multiple regression model we find that telomere length is a significant covariate of MCV (p = 7.6×10−8), independent of age, ethnicity, BMI, current smoking, alcohol consumption, iron or homocysteine levels. The effect of telomere length on MCV variation is comparable to the effect of smoking or alcohol consumption and is more significant in older individuals (p = 9.2×10−7 for >50 years vs. p = 0.0006 for <50 years of age). To our knowledge, this is the first report of an association between telomere length and red cell size in a large urban US population and suggests a biologic mechanism for macrocytosis of aging.

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Validation of a scoring system to establish the probability of myelodysplastic syndrome in patients with unexplained cytopenias or macrocytosis

Cited by 25 publications

References 14 publications

“Bone marrow aspirate automated counts on hematology analyzers: formulating a scoring system based on hematology parameters, to discriminate reactive versus myelodysplastic syndrome‐related bone marrows”

“Bone marrow aspirate automated counts on hematology analyzers: formulating a scoring system based on hematology parameters, to discriminate reactive versus myelodysplastic syndrome‐related bone marrows”

The Association between Red Cell Distribution Width and Mortality in Pediatric Acute Lymphoblastic Leukemia

Red Blood Cell Size Is Inversely Associated with Leukocyte Telomere Length in a Large Multi-Ethnic Population

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