Blood, 1 August 2006, Vol. 108, No. 3, pp. 1037-1044.
Prepublished online as a Blood First Edition Paper on March 30, 2006; DOI 10.1182/blood-2005-12-4916.
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NEOPLASIA
Diagnostic application of flow cytometric characteristics of CD34+ cells in low-grade myelodysplastic syndromes
Kiyoyuki Ogata,
Yoshifumi Kishikawa,
Chikako Satoh,
Hideto Tamura,
Kazuo Dan, and
Akio Hayashi
From the Division of Hematology and the Department of Bioregulation, Institute of Gerontology, Department of Medicine, Nippon Medical School, Tokyo, Japan; and the Department of Research and Development, Mitsubishi Kagaku Bio-Clinical Laboratories, Tokyo, Japan.
The diagnosis of myelodysplastic syndromes (MDS) without an increase in blasts and ringed sideroblasts (low-grade MDS without ringed sideroblasts [LGw/oRS]) may be problematic because dysplastic features are not specific to MDS and approximately 50% of patients with LGw/oRS lack chromosomal aberrations. Here, we report the usefulness of flow cytometric characteristics of CD34+ cells for LGw/oRS diagnosis. Bone marrow cells from LGw/oRS patients and controls (eg, cytopenic individuals without MDS) were analyzed using 4-color flow cytometry (FCM). We objectively determined reference ranges of 13 parameters related to CD34+ cells with data from controls. In LGw/oRS patients, various abnormalities of CD34+ cells—eg, decrease in CD34+ B-cell precursors, aberrant expression or overexpression of various antigens on CD34+ myeloblasts—were observed. We constructed a reproducible, flow cytometric scoring system for LGw/oRS diagnosis. High scores were observed in 16 of 27 LGw/oRS patients, regardless of the presence or absence of chromosomal aberrations, but not in any of the 90 controls. Among LGw/oRS patients with chromosomal aberrations, patients with trisomy 8 or del20(q) had low FCM scores (P = .002). As a result, most LGw/oRS patients were identified based on high FCM score, chromosomal aberration, or both.
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A. A. van de Loosdrecht, T. M. Westers, A. H. Westra, A. M. Drager, V. H. J. van der Velden, and G. J. Ossenkoppele
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Blood,
February 1, 2008;
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