Multiparameter flow cytometry is instrumental to distinguish myelodysplastic syndromes from non-neoplastic cytopenias. (February 2016)

• Record Type: Journal Article
• Authors: Cremers, Eline M.P.; Westers, Theresia M.; Alhan, Canan; Cali, Claudia; Wondergem, Mariëlle J.; Poddighe, Pino J.; Ossenkoppele, Gert J.; van de Loosdrecht, Arjan A.
• Is Part Of: European journal of cancer. Volume 54(2016)
• Page Start: 49
• Page End: 56
• Publication Date: 2016-02
• Subjects: Myelodysplastic syndromes -- Flow cytometry -- Cytopenias -- Diagnosis; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2015.11.013
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: Mandatory for the diagnosis of myelodysplastic syndromes (MDS) is the presence of dysplasia in >10% of cells within one or more cell lineages or presence of >15% ring sideroblasts or presence of MDS-associated cytogenetic (CG) abnormalities. Discrimination between neo-plastic and non-neoplastic causes of cytopenias can be challenging when dysplastic features by cytomorphology (CM) are minimal and CG abnormalities are absent or non-discriminating from other myeloid neoplastic disorders. This study evaluated a standard diagnostic approach in 379 patients with unexplained cytopenias and highlights the additional value of flow cytometry (FC) in patients with indeterminate CM and CG. CM reached no clear-cut diagnosis in 44% of the patients. Here, CG was able to identify two additional patients with MDS; other CG results did not reveal abnormalities or were not contributory. Based on the FC results, patients without a diagnosis by CM and CG were categorized 'no MDS-related features' (65%), 'limited number of MDS-related changes' (24%), and 'consistent with MDS' (11%). Patients were followed over time in an attempt to establish or confirm a diagnosis (median follow-up 391 d, range 20–1764). The specificity (true negative) of MDS-FC analysis calculated after follow-up was 95%. FC can aid as a valuable tool to exclude MDS when CM and additional CG are not conclusive in patients with cytopenia. Highlights: Flow cytometry has a high specificity in the exclusion of myelodysplastic syndromes (MDS) in cytopenic patients. Flow cytometry can add to the diagnosis in case of uncertain cytomorphology. Normal flow cytometry results predict a low probability of MDS within 1 year.