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Blood, 15 August 2001, Vol. 98, No. 4, pp. 979-987
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Diagnostic utility of flow cytometric immunophenotyping in
myelodysplastic syndrome
Maryalice Stetler-Stevenson,
Diane C. Arthur,
Nicholas Jabbour,
Xiu Y. Xie,
Jeff Molldrem,
A. John Barrett,
David Venzon, and
Margaret E. Rick
From the Laboratory of Pathology and the Biostatistics
and Data Management Section, Division of Clinical Sciences, National
Cancer Institute; Hematology Branch of the National Heart, Lung,
and Blood Institute; and Hematology Service, Warren Grant
Magnuson Clinical Center; all of the National Institutes of
Health, Bethesda, MD.
The myelodysplastic syndromes (MDSs) are characterized by bilineage
or trilineage dysplasia. Although diagnostic criteria are well
established for MDS, a significant number of patients have blood and
bone marrow findings that make diagnosis and classification difficult.
Flow cytometric immunophenotyping is an accurate and highly sensitive
method for detection of quantitative and qualitative abnormalities in
hematopoietic cells. Flow cytometry was used to study hematopoietic
cell populations in the bone marrow of 45 patients with straightforward
MDS. The results were compared with those obtained in a series of
patients with aplastic anemia, healthy donors, and patients with a
history of nonmyeloid neoplasia in complete remission. The
immunophenotypic abnormalities associated with MDS were defined, and
the diagnostic utility of flow cytometry was compared, with morphologic
and cytogenetic evaluations in 20 difficult cases. Although morphology
and cytogenetics were adequate for diagnosis in most cases, flow
cytometry could detect immunophenotypic abnormalities in cases when
combined morphology and cytogenetics were nondiagnostic. It is
concluded that flow cytometric immunophenotyping may help establish the
diagnosis of MDS, especially when morphology and cytogenetics are indeterminate.
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