Bone Marrow Cells from Myelodysplastic Syndromes Show Altered Immunophenotypic Profiles That May Contribute to the Diagnosis and Prognostic Stratification of the Disease: a Pilot Study on A Series of 56 Patients
Bone Marrow Cells from Myelodysplastic Syndromes Show Altered Immunophenotypic Profiles That May Contribute to the Diagnosis and Prognostic Stratification of the Disease: a Pilot Study on A Series of 56 Patients
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DOI：
10.1002/cyto.b.20513
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发表时间：
2010-05-01
影响因子：
3.4
通讯作者：
Orfao, Alberto
中科院分区：
文献类型：
--
作者：
Matarraz, Sergio;Lopez, Antonio;Orfao, Alberto
在骨髓增生异常综合征（MDS）中，已报道了免疫表型异常的异质性谱。然而，大多数研究仅限于分析CD 34（+）细胞和/或CD 34（-）细胞的其他主要亚群，通常没有探索免疫表型的诊断和预后影响。我们首次提出了一种免疫表型评分（IS）的基础上改变的分布和免疫表型特征的成熟/成熟区室的骨髓（BM）56例骨髓增生异常综合征患者的骨髓造血细胞，可能有助于疾病的精确诊断和预后评估。尽管在反应性BM中检测到MDS相关表型，但BM细胞的总体免疫表型谱允许有效区分MDS与正常和反应性BM，一旦在建议的IS中同时考虑了每个患者检测到的异常的数量和严重程度。有趣的是，在显示不良预后因素的MDS患者中以及在低级别与高级别病例中发现IS越来越高。最具信息性的预后因素包括CD 34（+）细胞数量、异常CD 34（-）/CD 117（+）前体细胞的存在、成熟中性粒细胞和CD 34（-）红系前体细胞的减少以及CD 36（-/lo）红系前体细胞数量的增加;此外，IS是总生存率的独立预后因素。一旦同时对检测到的异常的数量和严重程度进行评分，对成熟/成熟BM细胞的免疫表型异常进行评估，就可以有效区分MDS与正常和反应性BM。有趣的是，在具有不良预后特征和总生存期较短的MDS患者中发现IS逐渐升高。(C)2010年临床细胞计数学会
A heterogeneous spectrum of immunophenotypic abnormalities have been reported in myelodysplastic syndromes (MDS). However, most studies are restricted to the analysis of CD34(+) cells and/or other major subsets of CD34(-) cells, frequently not exploring the diagnostic and prognostic impact of immunophenotyping.Methods: We propose for the first time an immunophenotypic score (IS) based on the altered distribution and immunophenotypic features of maturing/mature compartments of bone marrow (BM) hematopoietic cells in 56 patients with MDS that could contribute to a refined diagnosis and prognostic evaluation of the disease.Results: Although MDS-associated phenotypes were detected in reactive BM, the overall immunophenotypic profile of BM cells allowed an efficient discrimination between MDS and both normal and reactive BM, once the number and degree of severity of the abnormalities detected per patient were simultaneously considered in the proposed IS. Interestingly, increasingly higher IS were found among patients with MDS showing adverse prognostic factors and in low-versus high-grade cases. The most informative prognostic factors included the number of CD34(+) cells, presence of aberrant CD34(-)/CD117(+) precursors, decreased mature neutrophils and CD34(-) erythroid precursors, and increased numbers of CD36(-/lo) erythroid precursors; in addition, the IS was an independent prognostic factor for overall survival.Conclusions: Assessment of immunophenotypic abnormalities of maturing/mature BM cells allows an efficient discrimination between MDS and both normal and reactive BM, once the number and degree of severity of the abnormalities detected are simultaneously scored. Interestingly, progressively higher IS were found among patients with MDS with adverse prognostic features and shorter overall survival. (C) 2010 Clinical Cytometry Society