Diagnostic utility of flow cytometric immunophenotyping in myelodysplastic syndrome

• Published in: Blood 2001-08, Vol.98 (4), p.979-987
• Main Authors: Stetler-Stevenson, Maryalice, Arthur, Diane C., Jabbour, Nicholas, Xie, Xiu Y., Molldrem, Jeff, Barrett, A. John, Venzon, David, Rick, Margaret E.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anemia, Aplastic - diagnosis; Anemia, Aplastic - pathology; Antigens, CD - analysis; Biological and medical sciences; Bone Marrow Cells - immunology; Bone Marrow Cells - pathology; Cytogenetic Analysis; Erythroid Precursor Cells - immunology; Erythroid Precursor Cells - pathology; Female; Flow Cytometry; Hematologic and hematopoietic diseases; Humans; Immunophenotyping; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Megakaryocytes - immunology; Megakaryocytes - pathology; Middle Aged; Myelodysplastic Syndromes - diagnosis; Myelodysplastic Syndromes - pathology; Myeloid Cells - immunology; Myeloid Cells - pathology
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V98.4.979

The myelodysplastic syndromes (MDSs) are characterized by bilineage or trilineage dysplasia. Although diagnostic criteria are well established for MDS, 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 detection of quantitative and qualitative abnormalities in hematopoietic cells. Flow cytometry was used to study hematopoietic cell populations in the bone marrow of 45 patients with straightforward MDS. The results were compared with those obtained in a series of patients with aplastic anemia, healthy donors, and patients with a history of nonmyeloid neoplasia in complete remission. The immunophenotypic abnormalities associated with MDS were defined, and the diagnostic utility of flow cytometry was compared, with morphologic and cytogenetic evaluations in 20 difficult cases. Although morphology and cytogenetics were adequate for diagnosis in most cases, flow cytometry could detect immunophenotypic abnormalities in cases when combined morphology and cytogenetics were nondiagnostic. It is concluded that flow cytometric immunophenotyping may help establish the diagnosis of MDS, especially when morphology and cytogenetics are indeterminate.