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Blood, 1 February 2008, Vol. 111, No. 3, pp. 1067-1077. Prepublished online as a Blood First Edition Paper on October 30, 2007; DOI 10.1182/blood-2007-07-098764. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-07-098764v1 111/3/1067    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by van de Loosdrecht, A. A. Articles by Ossenkoppele, G. J. Search for Related Content PubMed PubMed Citation Articles by van de Loosdrecht, A. A. Articles by Ossenkoppele, G. J. Related Collections Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Identification of distinct prognostic subgroups in low- and intermediate-1–risk myelodysplastic syndromes by flow cytometry Arjan A. van de Loosdrecht1, Theresia M. Westers1, August H. Westra1, Angelika M. Dräger1, Vincent H. J. van der Velden2, and Gert J. Ossenkoppele1 1 Department of Hematology, Vrije Universiteit (VU) University Medical Center, VU-Institute for Cancer and Immunology, Amsterdam; 2 Department of Immunology, Erasmus Medical Center, Rotterdam, the Netherlands The World Health Organization (WHO) classification contributes to refined classification and prognostication of myelodysplastic syndromes (MDSs). Flow cytometry might add significantly to diagnostic and prognostic criteria. Our analysis of bone marrow samples from 50 patients with MDS showed aberrant expression of differentiation antigens in the myelomonocytic lineage. This also accounted for refractory anemia (RA) with or without ringed sideroblasts (RS), indicating multilineage dysplasia. In 38% of patients, CD34+ myeloid blasts expressed CD5, CD7, or CD56. Flow cytometry data were translated into a numerical MDS flow-score. Flow-scores increased significantly from RA with or without RS, refractory cytopenia with multilineage dysplasia (RCMD) with or without RS up to refractory anemia with excess of blasts-1 (RAEB-1) and RAEB-2. No significant differences were observed between WHO cytogenetic subgroups. Flow-scores were highly heterogeneous within International Prognostic Scoring System (IPSS) subgroups. Patients in progression to advanced MDS or acute myeloid leukemia had a significantly higher flow-score compared with non–transfusion-dependent patients. In 60% of patients with transfusion dependency or progressive disease, myeloid blasts expressed CD7 or CD56, in contrast to only 9% of non–transfusion-dependent patients. Moreover, all patients with pure RA with or without RS with aberrant myeloid blasts showed an adverse clinical course. In conclusion, flow cytometry in MDS identified aberrancies in the myelomonocytic lineage not otherwise determined by cytomorphology. In addition, flow cytometry identified patients at risk for transfusion dependency and/or progressive disease independent of known risk groups, which might have impact on treatment decisions and the prognostic scoring system in the near future. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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