| Multicentre validation of a reproducible flow cytometric score for the diagnosis of low-risk myelodysplastic syndromes: results of a European LeukemiaNET study. | |
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MedLine Citation:
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PMID: 22315489 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background. Current World Health Organization classification of myelodysplastic syndromes is based on morphological evaluation of marrow dysplasia. In clinical practice, the reproducibility for recognition of dysplasia is usually poor especially in cases that lack specific markers such as ring sideroblasts and clonal cytogenetic abnormalities. Design and Methods. We aimed to develop and validate a flow cytometric score for the diagnosis of myelodysplastic syndrome. Four reproducible parameters were analyzed: CD34+ myeloblast-related and B-progenitor-related cluster size (defined by CD45 expression and side scatter characteristics on CD34+ marrow cells), myeloblast CD45 expression and granulocyte side scatter value. Study comprised a "learning cohort" (n=538) to define the score and a "validation cohort" (n=259) to confirm its diagnostic value. Results. With respect to non-clonal cytopenias, patients with myelodysplastic syndrome presented increased myeloblast-related cluster size, decreased B-progenitor-related cluster size, aberrant CD45 expression and reduced granulocyte side scatter (P<.001). To define the flow cytometric score, these four parameters were combined in a regression model and the weight for each variable was estimated based on coefficients from that model. In the learning cohort a correct diagnosis of myelodysplastic syndrome was formulated in 198/281 cases (sensitivity 70%), while18 false-positive results were noticed among 257 controls (specificity 93%). Sixty-five percent of patients without specific markers of dysplasia (ring sideroblasts and clonal cytogenetic abnormalities) were correctly classified. A high flow cytometric score value was associated with multilineage dysplasia (P=.001), transfusion-dependency (P=.02), and poor risk-cytogenetics (P=.04). Comparable sensitivity and specificity were obtained in the validation cohort (69% and 92%, respectively). The likelihood ratio of the flow cytometric score was 10.Conclusions. Flow cytometric score may help establish the diagnosis of myelodysplastic syndrome, especially when morphology and cytogenetics are indeterminate. |
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Authors:
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Matteo G Della Porta; Cristina Picone; Cristiana Pascutto; Luca Malcovati; Hideto Tamura; Hiroshi Handa; Magdalena Czader; Sylvie Freeman; Paresh Vyas; Anna Porwit; Leonie Saft; Theresia M Westers; Canan Alhan; Caludia Cali; Arjan A Van de Loosdrecht; Kiyoyuki Ogata |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-7 |
Journal Detail:
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Title: Haematologica Volume: - ISSN: 1592-8721 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-8 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417435 Medline TA: Haematologica Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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University of Pavia, Policlinico San Matteo, Pavia, Italy; |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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