Abnormal CD13/HLA-DR Expression Pattern on Myeloblasts Predicts Development of Myeloid Neoplasia in Patients With Clonal Cytopenia of Undetermined Significance. Issue 4 (8th August 2022)

• Record Type: Journal Article
• Authors: Jevremovic, Dragan; Nanaa, Ahmad; Geyer, Susan M; Timm, Michael; Azouz, Haya; Hengel, Cynthia; Reberg, Alexander; He, Rong; Viswanatha, David; Salama, Mohamad E; Shi, Min; Olteanu, Horatiu; Horna, Pedro; Otteson, Gregory; Greipp, Patricia T; Xie, Zhuoer; Alkhateeb, Hassan B; Hogan, William; Litzow, Mark; Patnaik, Mrinal M; Shah, Mithun; Al-Kali, Aref; Nguyen, Phuong L
• Is Part Of: American journal of clinical pathology. Volume 158:Issue 4(2022)
• Page Start: 530
• Page End: 536
• Publication Date: 2022-08-08
• Subjects: Flow cytometry -- CCUS -- MDS -- Myeloid neoplasia; Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqac083
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Objectives: Patients with clonal cytopenia of undetermined significance (CCUS) are at increased risk of developing myeloid neoplasia (MN). We evaluated whether a simple flow cytometry immunophenotyping (FCIP) assay could differentiate the risk of development of MN in patients with CCUS. Methods: Bone marrow aspirates were assessed by FCIP panel in a cohort of 80 patients identified as having CCUS based on next-generation sequencing or cytogenetics from March 2015 to May 2020, with available samples. Flow cytometric assay included CD13/HLA-DR expression pattern on CD34-positive myeloblasts; CD13/CD16 pattern on maturing granulocytic precursors; and aberrant expression of CD2, CD7, or CD56 on CD34-positive myeloblasts. Relevant demographic, comorbidity, and clinical and laboratory data, including the type and extent of genetic abnormalities, were extracted from the electronic health record. Results: In total, 17 (21%) patients with CCUS developed MN over the follow-up period (median survival follow-up, 28 months [95% confidence interval, 19-31]). Flow cytometry immunophenotyping abnormalities, including the aberrant pattern of CD13/HLA-DR expression, as detected at the time of the diagnosis of CCUS, were significantly associated with risk of developing MN (hazard ratio, 2.97; P = .006). Additional FCIP parameters associated with the development of MN included abnormal expression of CD7 on myeloblasts and the presence vs absence of any FCIP abnormality. Conclusions: A simple FCIP approach that includes assessment of CD13/HLA-DR pattern on CD34-positive myeloblasts can be useful in identifying patients with CCUS at higher risk of developing MN.