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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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Submitted December 13, 2005
Accepted March 16, 2006
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
Division of Hematology, Department of Medicine, Nippon Medical School, Tokyo, Japan
Department of Research and Development, Mitsubishi Kagaku Bio-Clinical Laboratories, Tokyo, Japan
Division of Hematology, Department of Medicine, Nippon Medical School, Tokyo, Japan; Department of Bioregulation, Institute of Gerontology, Department of Medicine, Nippon Medical School, Kanagawa, Japan
* Corresponding author; email: ogata{at}nms.ac.jp.
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 about 50% of LGw/oRS patients lack chromosomal aberrations. Here, we report the utility of flow cytometric characteristics of CD34+ cells for LGw/oRS diagnosis. Bone marrow cells from LGw/oRS patients and controls (e.g., cytopenic individuals without MDS) were analyzed using four-color flow cytometry (FCM). We objectively determined reference ranges of 13 parameters relating to CD34+ cells using data from controls. In LGw/oRS patients, various abnormalities of CD34+ cells were observed, e.g., a decrease in CD34+ B-cell precursors and aberrant or overexpression of various antigens on CD34+ myeloblasts. Then, 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 90 controls. Among LGw/oRS patients with chromosomal aberrations, patients with trisomy 8 or del20(q) were notably associated with a low FCM score (P = .0019). As a result, most LGw/oRS patients were identified based on a high FCM score and/or chromosomal aberrations.
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