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Prepublished online as a Blood First Edition Paper on June 14, 2002; DOI 10.1182/blood-2002-01-0230.

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2002-01-0230v1
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Blood, 1 October 2002, Vol. 100, No. 7, pp. 2349-2356

CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS

Immunophenotypic clustering of myelodysplastic syndromes

Marc Maynadié, Françoise Picard, Bernard Husson, Bernard Chatelain, Yvan Cornet, Geneviève Le Roux, Lydia Campos, Alex Dromelet, Pascalle Lepelley, Hélène Jouault, Michèle Imbert, Michelle Rosenwadj, Véronique Vergé, Philippe Bissières, Martine Raphaël, Marie Christine Béné, Jean Feuillard, and the Groupe d'Etude Immunologique des Leucémies (GEIL)

From the Service d'Hématologie Biologique, CHU Bocage, Dijon, France; Service d'Hématologie Biologique Hôpital Cochin AP-HP and Laboratoire d'Immuno-Hématologie, Hôpital Saint-Antoine, Paris, France; Laboratoire de Biologie Clinique, Hôpital de Jolimont, Haine Saint Paul, Belgium; Laboratoire d'Hématologie, Cliniques Universitaires UCL Mont Godinne, Yvoir, Belgium; Laboratoire d'Hématologie, Hôpital Nord, CHU Saint Etienne, France; Laboratoire d'Hématologie A, Hôpital Calmette, CHU Lille, France; Laboratoire d'Hématologie, Hôpital Henri Mondor AP-HP, Créteil, France; Laboratoire d'Immunologie, Faculté de Médecine, Vandoeuvre-Les-Nancy, France; and Service d'Hématologie Biologique, Hôpital Avicenne AP-HP et EA 3406 ATHSCO, Université Paris 13, Bobigny, France. GEIL: Groupe d'Etude Immunologique des Leucémies.

Myelodysplastic syndromes (MDSs) are heterogeneous diseases of bone marrow (BM) cell precursors for which immunophenotypic characterization is still considered irrelevant despite the accuracy and sensitivity of flow cytometry techniques. The aim of this study was to determine whether immunophenotypic abnormalities could be defined in MDSs and could correlate with the French-American-British classification and cytogenetics. Analysis was performed on 275 BM samples (207 MDS patients, 68 controls) and 25 control blood samples. Immunophenotyping was based on a primary gating of blast cells, monocytes, and granulocytes according to CD45 antigen expression and side scatter light diffraction. Immunophenotypic hierarchical clustering was performed to analyze the results. The data obtained show that (1) immunophenotypic clustering partly discriminates patients with refractory anemia with excess blasts/refractory anemia with excess blasts in transformation (RAEB/RAEB-T), chronic myelomonocytic leukemia (CMML), and refractory anemia/refractory anemia with ring sideroblasts (RA/RARS) for CD45lo blast cells and patients with RA/CMML, RARS, and RAEB/RAEB-T for CD45hi/side scatterhi (SShi) granulocytes; (2) the most discriminating markers were CD16, CD34, CD36, CD38, CD71, and HLA-DR for blast cells and CD11b, CD13, CD33, CD36, CD38, CD71, and HLA-DR for CD45hi/SShi granulocytes; (3) clusters related to CD34 expression were associated with high levels of blast cells on BM smear; (4) clusters related to high levels of CD36 expression on CD45lo blast cells and CD45hi/SShi granulocytes were associated with a poor International Prognosis Scoring System score; and (5) high levels of CD71 expression on CD45hi/SShi granulocytes were associated with the RARS category. These results show a close relationship between immunophenotypic abnormalities and BM dysplasia and suggest that flow cytometry could be a future tool for the characterization of MDSs.

© 2002 by The American Society of Hematology.
 

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