Implementation of erythroid lineage analysis by flow cytometry in diagnostic models for myelodysplastic syndromes

Eline M.P. Cremers, Theresia M. Westers, Canan Alhan, Claudia Cali, Heleen A. Visser-Wisselaar, Dana A. Chitu, Vincent H.J. van der Velden, Jeroen G. te Marvelde, Saskia K. Klein, Petra Muus, Edo Vellenga, Georgina E. de Greef, Marie Cecile C.J.C. Legdeur, Pierre W. Wijermans, Marian J.P.L. Stevens-Kroef, Pedro da Silva-Coelho, Joop H. Jansen, Gert J. Ossenkoppele, Arjan A. van de Loosdrecht*, HOVON89 study group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Flow cytometric analysis is a recommended tool in the diagnosis of myelodysplastic syndromes. Current flow cytometric approaches evaluate the (im)mature myelo-/monocytic lineage with a median sensitivity and specificity of ~71% and ~93%, respectively. We hypothesized that the addition of erythroid lineage analysis could increase the sensitivity of flow cytometry. Hereto, we validated the analysis of erythroid lineage parameters recommended by the International/European LeukemiaNet Working Group for Flow Cytometry in Myelodysplastic Syndromes, and incorporated this evaluation in currently applied flow cytometric models. One hundred and sixty-seven bone marrow aspirates were analyzed; 106 patients with myelodysplastic syndromes, and 61 cytopenic controls. There was a strong correlation between presence of erythroid aberrancies assessed by flow cytometry and the diagnosis of myelodysplastic syndromes when validating the previously described erythroid evaluation. Furthermore, addition of erythroid aberrancies to two different flow cytometric models led to an increased sensitivity in detecting myelodysplastic syndromes: from 74% to 86% for the addition to the diagnostic score designed by Ogata and colleagues, and from 69% to 80% for the addition to the integrated flow cytometric score for myelodysplastic syndromes, designed by our group. In both models the specificity was unaffected. The high sensitivity and specificity of flow cytometry in the detection of myelodysplastic syndromes illustrates the important value of flow cytometry in a standardized diagnostic approach.

Original languageEnglish
Pages (from-to)320-326
Number of pages7
JournalHaematologica
Volume102
Issue number2
DOIs
Publication statusPublished - 2017

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