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Combined flow cytometric assessment of CD45, HLA-DR, CD34, and CD117 expression is a useful approach for reliable quantification of blast cells in myelodysplastic syndromes.
- Source :
-
Cytometry. Part B, Clinical cytometry [Cytometry B Clin Cytom] 2013 May; Vol. 84 (3), pp. 157-66. Date of Electronic Publication: 2013 Mar 08. - Publication Year :
- 2013
-
Abstract
- Background: Quantification of bone marrow (BM) blasts by cytomorphology is essential for the diagnosis of myelodysplastic syndromes (MDS). Owing to its subjectivity and the potential impact of dysplastic features on accurate identification of blast cells, more objective approaches are required, multiparameter flow cytometry (MFC) being a particularly promising approach in this regard. However, no consensus exists about the optimal combination of markers and strategy to be used.<br />Methods: BM blast counts from 74 MDS patients were evaluated by morphology versus four different MFC phenotypic criteria: "CD34⁺", "CD34⁺ and/or CD117⁺", "CD34⁺, and/or CD117⁺ HLA-DR⁺", and "CD34⁺ and CD117⁺ HLA-DR⁺ plus CD64⁺ CD14(-/lo) " cells. For each criterium, the percentage of blasts was calculated using either all BM nucleated cells or non-erythroid CD45⁺ cells as denominator. RESULTS.: The number of "CD34⁺ and/or CD117⁺ HLA-DR⁺"cells showed the highest correlation and agreement with morphological counts, only a minor proportion of cases being misclassified by MFC vs. morphology for the >5% and >10% classification thresholds. In turn, a CD34⁺ phenotype was insufficient to correctly identify and quantify blasts. Conversely, usage of non-erythroid BM cells as denominator, or inclusion of "CD34⁺ and/or CD117⁺ HLA-DR⁺ plus CD64⁺ CD14(-lo") cells were both associated with overestimated blast counts.<br />Conclusions: Quantification of "CD34⁺ and/or CD117⁺ HLA-DR⁺" cells (from all nucleated BM cells) by MFC is an efficient method for the enumeration of blasts in MDS. However, caution should be taken with replacing morphology by MFC blast counts; its combined use may rather provide complementary information increasing the accuracy and reproducibility of BM blast cell counts in these patients.<br /> (Copyright © 2013 International Clinical Cytometry Society.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Antigens, CD34 genetics
Biomarkers analysis
Cell Count
Female
Flow Cytometry
Gene Expression
Granulocyte Precursor Cells pathology
HLA-DR Antigens genetics
Humans
Immunophenotyping
Leukocyte Common Antigens analysis
Leukocyte Common Antigens genetics
Male
Middle Aged
Myelodysplastic Syndromes genetics
Myelodysplastic Syndromes pathology
Proto-Oncogene Proteins c-kit genetics
Reproducibility of Results
Antigens, CD34 analysis
Granulocyte Precursor Cells metabolism
HLA-DR Antigens analysis
Myelodysplastic Syndromes diagnosis
Proto-Oncogene Proteins c-kit analysis
Subjects
Details
- Language :
- English
- ISSN :
- 1552-4957
- Volume :
- 84
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Cytometry. Part B, Clinical cytometry
- Publication Type :
- Academic Journal
- Accession number :
- 23475532
- Full Text :
- https://doi.org/10.1002/cyto.b.21087