Immunophenotypic analysis of erythroid dysplasia in myelodysplastic syndromes. A report from the IMDSFlow working group
Immunophenotypic analysis of erythroid dysplasia in myelodysplastic syndromes. A report from the IMDSFlow working group
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DOI：
10.3324/haematol.2016.147835
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发表时间：
2017-02-01
期刊：
影响因子：
10.1
通讯作者：
van De Loosdrecht, Arjan A.
中科院分区：
文献类型：
--
作者：
Westers, Theresia M.;Cremers, Eline M. P.;van De Loosdrecht, Arjan A.
目前对于骨髓增生异常综合征的诊断推荐流式细胞术是一种信息丰富的工具。大多数流式细胞术方案侧重于祖细胞的分析和成熟的骨髓单核细胞谱系的评估。然而，骨髓增生异常综合征最常见的特征之一是贫血，这可能与红细胞生成障碍有关。因此，分析有核红细胞的流式细胞术特征的变化可以补充现有的流式细胞术工具。本文报道的IMDSFlow工作组的多中心研究侧重于定义流式细胞术参数，以便区分与骨髓增生异常综合征相关的红细胞生成与非克隆性细胞减少症。来自学习队列的数据在骨髓增生异常和对照组之间进行比较，并在单独的队列中验证结果。学习队列包括245例骨髓增生异常，290例病理对照和142例正常对照；验证队列为129例骨髓增生异常，153例病理对照，49例正常对照。在学习队列中进行的多因素logistic回归分析显示，CD36和CD71的表达分析（以变异系数表示）；结合CD71荧光强度和CD117+红系祖细胞的百分比，可以最好地区分骨髓增生异常综合征和非克隆性细胞减少症（特异性90%；95%置信区间：84-94%）。该标记集的高特异性在验证队列中得到证实（92%；95%置信区间：86-97%）。这种红细胞流式细胞术标记物组合可以改善对疑似骨髓发育不良的细胞减少性病例的评估，特别是当与骨髓单核细胞谱系的流式细胞术结合时。
Current recommendations for diagnosing myelodysplastic syndromes endorse flow cytometry as an informative tool. Most flow cytometry protocols focus on the analysis of progenitor cells and the evaluation of the maturing myelomonocytic lineage. However, one of the most frequently observed features of myelodysplastic syndromes is anemia, which may be associated with dyserythropoiesis. Therefore, analysis of changes in flow cytometry features of nucleated erythroid cells may complement current flow cytometry tools. The multicenter study within the IMDSFlow Working Group reported herein focused on defining flow cytometry parameters that enable discrimination of dyserythropoiesis associated with myelodysplastic syndromes from non-clonal cytopenias. Data from a learning cohort were compared between myelodysplasia and controls and results were validated in a separate cohort. The learning cohort comprised 245 myelodysplasia cases, 290 pathological and 142 normal controls; the validation cohort 129 myelodysplasia cases, 153 pathological and 49 normal controls. Multivariate logistic regression analysis performed in the learning cohort revealed that analysis of expression of CD36 and CD71 (expressed as coefficient of variation); in combination with CD71 fluorescence intensity and the percentage of CD117+ erythroid progenitors provided the best discrimination between myelodysplastic syndromes and non-clonal cytopenias (specificity 90%; 95% confidence interval: 84-94%). The high specificity of this marker set was confirmed in the validation cohort (92%; 95% confidence interval: 86-97%). This erythroid flow cytometry marker combination may improve the evaluation of cytopenic cases with suspected myelodysplasia, particularly when combined with flow cytometry assessment of the myelomonocytic lineage.