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

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

Autor Sandes, Alex Freire Autor UNIFESP Google Scholar
Kerbauy, Daniela Márcia Bahia Autor UNIFESP Google Scholar
Matarraz, Sergio Google Scholar
Chauffaille, Maria de Lourdes Lopes Ferrari Autor UNIFESP Google Scholar
Lopez, Antonio Google Scholar
Orfao, Alberto Google Scholar
Yamamoto, Mihoko Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Univ Salamanca
Resumo 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. 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+CD14lo cells were both associated with overestimated blast counts. 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. (c) 2013 International Clinical Cytometry Society
Palavra-chave myelodysplastic syndromes
blast cell count
flow cytometry
Idioma Inglês
Financiador Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Fondo Europeo de Desarrollo Regional (FEDER), the Instituto de Salud Carlos III, Ministerio de Economia y Competitividad, Madrid, Spain
Número do financiamento FAPESP: 05/57792-0
CNPq: 142968/2006-4
CAPES: PDEE BEX 1025/05-8
RTICC: RD12/0036/0048
Data de publicação 2013-05-01
Publicado em Cytometry Part B-clinical Cytometry. Hoboken: Wiley-Blackwell, v. 84B, n. 3, p. 157-166, 2013.
ISSN 1552-4949 (Sherpa/Romeo, fator de impacto)
Publicador Wiley-Blackwell
Extensão 157-166
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000318041900005
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