Diagnostic utility of flow cytometry in low-grade myelodysplastic syndromes: a prospective validation study

被引:134
作者
Ogata, Kiyoyuki [1 ]
Della Porta, Matteo G. [2 ,3 ]
Malcovati, Luca [2 ,3 ]
Picone, Cristina [2 ,3 ]
Yokose, Norio [4 ]
Matsuda, Akira [5 ]
Yamashita, Taishi [6 ]
Tamura, Hideto
Tsukada, Junichi [7 ]
Dan, Kazuo
机构
[1] Nippon Med Sch, Div Hematol, Dept Med, Bunkyo Ku, Tokyo 1138603, Japan
[2] Univ Pavia, Dept Hematol Oncol, Sch Med, I-27100 Pavia, Italy
[3] Fdn IRCCS Policlin San Matteo, Pavia, Italy
[4] Chiba Hokusoh Hosp, Div Hematol, Dept Internal Med, Nippon Med Sch, Chiba, Japan
[5] Saitama Med Univ, Dept Hematol, Saitama Int Med Ctr, Saitama, Japan
[6] Tokyo Univ Sci, Dept Ind Sci & Technol, Chiba, Japan
[7] Univ Occupat & Environm Hlth, Dept Internal Med 1, Sch Med, Fukuoka, Japan
来源
HAEMATOLOGICA-THE HEMATOLOGY JOURNAL | 2009年 / 94卷 / 08期
关键词
myelodysplastic syndromes; flow cytometry; diagnosis; SCORING SYSTEM; CLASSIFICATION; FEATURES; CELLS;
D O I
10.3324/haematol.2009.008532
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background The diagnosis of myelodysplastic syndromes is not always straightforward when patients lack specific diagnostic markers, such as blast excess, karyotype abnormality and ringed sideroblasts. Design and Methods We designed a flow cytometry protocol applicable in many laboratories and verified its diagnostic utility in patients without those diagnostic markers. The cardinal parameters, analyzable from one cell aliquot, were myeloblasts (%), B-cell progenitors (%), myeloblast CD45 expression, and channel number of side scatter where the maximum number of granulocytes occurs. The adjunctive parameters were CD11b, CD15, and CD56 expression (%) on myeloblasts. Marrow samples from 106 control patients with cytopenia and 134 low-grade myelodysplastic syndromes patients, including 81 lacking both ringed sideroblasts and cytogenetic aberrations, were prospectively analyzed in Japan and Italy. Results Data outside the predetermined reference range in 2 or more parameters (multiple abnormalities) were common in myelodysplastic syndromes patients. In those lacking ringed sideroblasts and cytogenetic aberrations, multiple abnormalities were observed in 8/26 Japanese (30.8%) and 37/55 Italians (67.03%) when the cardinal parameters alone were considered, and in 17/26 Japanese (65.4%) and 42/47 Italians (89.4%) when all parameters were taken into account. Multiple abnormalities were rare in controls. When data from all parameters were used, the diagnostic sensitivities were 65% and 89%, specificities were 98% and 90%, and likelihood ratios were 28.1 and 8.5 for the Japanese and Italian cohorts, respectively. Conclusions This protocol can be used in the diagnostic work-up of low-grade myelodysplastic syndromes patients who lack specific diagnostic markers, although further improvement in diagnostic power is desirable.
引用
收藏
页码:1066 / 1074
页数:9
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