Immunophenotypic Lineage Assessment By Multiparameter Flow Cytometry Provides More Precise MDS Prognosis

• Published in: Blood 2020-11, Vol.136 (Supplement 1), p.9-10
• Main Authors: Onyekwere, Ikenna, Garcia, Julie Perilla, Menghrajani, Kamal, Chan, Alexander, Famulare, Christopher, Patel, Minal A, Philip, John, Tallman, Martin S., Klimek, Virginia M., Levine, Ross L., Xiao, Wenbin, Glass, Jacob L
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2020-143154

Background: Mixed phenotype acute leukemia is a rare disease characterized by an expanded blast population exhibiting multiple lineage features. It is a diagnosis of exclusion, and we and others have observed that AML-MRC or therapy-related AML cases may also exhibit similar features. We therefore sought to determine whether multi-lineage expression is present in de-novo and therapy-related MDS and whether it has an impact on clinical outcomes. Methods: We reviewed pathology, flow cytometry, cytogenetic, and molecular reports from patients seen at Memorial Sloan Kettering Cancer Center between 1996 and 2020 and identified 472 patients diagnosed with MDS using a combination of custom natural language processing tools and manual review. Cox proportional hazards modeling was performed to assess the contribution of patient characteristics, pathology, flow cytometric, cytogenetic, and molecular characteristics to overall survival (OS). Fisher's exact testing was used to assess the association of individual features. Results: We found that an abnormal myeloid lineage signature was associated with poorer OS after adjusting for age, cytogenetics, and molecular features (HR=2.3, p