Document Detail


Diagnostic utility of flow cytometry in low-grade myelodysplastic syndromes: a prospective validation study.
MedLine Citation:
PMID:  19546439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 (67.3%) 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.
Authors:
Kiyoyuki Ogata; Matteo G Della Porta; Luca Malcovati; Cristina Picone; Norio Yokose; Akira Matsuda; Taishi Yamashita; Hideto Tamura; Junichi Tsukada; Kazuo Dan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2009-06-22
Journal Detail:
Title:  Haematologica     Volume:  94     ISSN:  1592-8721     ISO Abbreviation:  Haematologica     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-31     Completed Date:  2009-12-07     Revised Date:  2010-09-27    
Medline Journal Info:
Nlm Unique ID:  0417435     Medline TA:  Haematologica     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  1066-74     Citation Subset:  IM    
Affiliation:
Division of Hematology, Department of Medicine, Nippon Medical School, Tokyo, Japan. ogata@nms.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antigens, CD11b / analysis
Antigens, CD15 / analysis
Antigens, CD45 / analysis
Antigens, CD56 / analysis
Bone Marrow Cells / metabolism
Female
Flow Cytometry / methods*
Humans
Immunophenotyping / methods
Male
Middle Aged
Myelodysplastic Syndromes / blood,  diagnosis*,  immunology
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Antigens, CD11b; 0/Antigens, CD15; 0/Antigens, CD56; EC 3.1.3.48/Antigens, CD45
Comments/Corrections
Comment In:
Haematologica. 2009 Aug;94(8):1041-3   [PMID:  19644135 ]

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