Side scatter ratio of the CD105-positive and CD105-negative red blood cell fractions is useful for the detection of low-grade myelodysplastic neoplasms by flow cytometry

• Published in: American journal of clinical pathology 2024-08, Vol.162 (2), p.191-201
• Main Authors: Wang, Zijan, Ciarlini, Pedro C, Oduro, Kwadwo A, Gadde, Ramya, O’Neill, Stacey, Zhao, Chen, Meyerson, Howard J
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antigens, CD - metabolism; Blood; Bone mass; CD105 antigen; CD34 antigen; Endoglin - blood; Endoglin - metabolism; Erythrocytes; Erythrocytes - pathology; Female; Flow Cytometry; Hemopoiesis; Humans; Leukocytes (granulocytic); Lymphocytes B; Male; Middle Aged; Multivariate analysis; Myelodysplastic Syndromes - blood; Myelodysplastic Syndromes - diagnosis; Myelodysplastic Syndromes - pathology; Progenitor cells; Retrospective Studies; Tumors; Young Adult
• ISSN: 0002-9173; 1943-7722; 1943-7722
• DOI: 10.1093/ajcp/aqae021

Abstract Objectives We assessed the utility of red blood cell (RBC) CD105 and side scatter (SSC) parameters by flow cytometry for the detection of low-grade myelodysplastic neoplasms (MDS) in bone marrow specimens. Methods Ten RBC parameters incorporating CD105 or SSC combined with the Meyerson-Alayed scoring system (MASS) metrics were retrospectively evaluated by flow cytometry for utility in detecting low-grade MDS (n = 56) compared with cytopenic controls (n = 86). Results Myelodysplastic neoplasms were associated with 7 of the RBC parameters in univariate analysis. Multivariate analysis using cutoff values based on optimal and 95% specificity levels of the RBC metrics and the MASS parameters revealed the SSC ratio of CD105-positive and CD105-negative RBC fractions (CD105+/− SSC); the percentage and coefficient of variation of the CD105-positive fraction of RBCs (CD105%, CD105+CV) emerged as significant RBC variables. Two simple scoring schemes using these RBC values along with MASS parameters were identified: 1 using CD105+/− SSC, CD105%, and CD105+CV combined with the percentage of CD177-positive granulocytes (CD177%), myeloblast percentage (CD34%), and granulocyte SSC (GranSSC), and the other incorporating CD105+/− SSC, CD105+CV, CD177%, CD34%, GranSSC, and B-cell progenitor percentage. Both demonstrated a sensitivity of approximately 80%, with a specificity of roughly 90% for the detection of MDS compared with cytopenic controls. Conclusions The red blood cell parameter, CD105+/− SSC, appears to be beneficial in the evaluation of low-grade MDS by flow cytometry.