Maynadié Marc, Picard Françoise, Husson Bernard, Chatelain Bernard, Cornet Yvan, Le Roux Geneviève, Campos Lydia, Dromelet Alex, Lepelley Pascalle, Jouault Hélène, Imbert Michèle, Rosenwadj Michelle, Vergé Véronique, Bissières Philippe, Raphaël Martine, Béné Marie Christine, Feuillard Jean
Service d'Hématologie Biologique, CHU Bocage, Dijon, France.
Blood. 2002 Oct 1;100(7):2349-56. doi: 10.1182/blood-2002-01-0230.
Myelodysplastic syndromes (MDSs) are heterogeneous diseases of bone marrow (BM) cell precursors for which immunophenotypic characterization is still considered irrelevant despite the accuracy and sensitivity of flow cytometry techniques. The aim of this study was to determine whether immunophenotypic abnormalities could be defined in MDSs and could correlate with the French-American-British classification and cytogenetics. Analysis was performed on 275 BM samples (207 MDS patients, 68 controls) and 25 control blood samples. Immunophenotyping was based on a primary gating of blast cells, monocytes, and granulocytes according to CD45 antigen expression and side scatter light diffraction. Immunophenotypic hierarchical clustering was performed to analyze the results. The data obtained show that (1) immunophenotypic clustering partly discriminates patients with refractory anemia with excess blasts/refractory anemia with excess blasts in transformation (RAEB/RAEB-T), chronic myelomonocytic leukemia (CMML), and refractory anemia/refractory anemia with ring sideroblasts (RA/RARS) for CD45(lo) blast cells and patients with RA/CMML, RARS, and RAEB/RAEB-T for CD45(hi)/side scatter(hi) (SS(hi)) granulocytes; (2) the most discriminating markers were CD16, CD34, CD36, CD38, CD71, and HLA-DR for blast cells and CD11b, CD13, CD33, CD36, CD38, CD71, and HLA-DR for CD45(hi)/SS(hi) granulocytes; (3) clusters related to CD34 expression were associated with high levels of blast cells on BM smear; (4) clusters related to high levels of CD36 expression on CD45(lo) blast cells and CD45(hi)/SS(hi) granulocytes were associated with a poor International Prognosis Scoring System score; and (5) high levels of CD71 expression on CD45(hi)/SS(hi) granulocytes were associated with the RARS category. These results show a close relationship between immunophenotypic abnormalities and BM dysplasia and suggest that flow cytometry could be a future tool for the characterization of MDSs.
骨髓增生异常综合征（MDS）是骨髓细胞前体的异质性疾病，尽管流式细胞术技术具有准确性和敏感性，但免疫表型特征仍被认为无关紧要。本研究的目的是确定MDS中是否可以定义免疫表型异常，以及是否与法美英分类和细胞遗传学相关。对275份骨髓样本（207例MDS患者，68例对照）和25份对照血液样本进行了分析。免疫表型分析基于根据CD45抗原表达和侧向散射光衍射对原始细胞、单核细胞和粒细胞进行的初步门控。进行免疫表型层次聚类以分析结果。获得的数据表明：（1）免疫表型聚类在一定程度上区分了原始细胞CD45(lo)的有过多原始细胞的难治性贫血/转化中有过多原始细胞的难治性贫血（RAEB/RAEB-T）、慢性粒单核细胞白血病（CMML）以及难治性贫血/有环形铁粒幼细胞的难治性贫血（RA/RARS）患者，以及原始细胞CD45(hi)/侧向散射(hi)（SS(hi)）粒细胞的RA/CMML、RARS和RAEB/RAEB-T患者；（2）最具区分性的标志物是原始细胞的CD16、CD34、CD36、CD38、CD71和HLA-DR，以及CD45(hi)/SS(hi)粒细胞的CD11b、CD13、CD33、CD36、CD38、CD71和HLA-DR；（3）与CD34表达相关的聚类与骨髓涂片上高水平的原始细胞相关；（4）与CD45(lo)原始细胞和CD45(hi)/SS(hi)粒细胞上高水平的CD36表达相关的聚类与不良的国际预后评分系统评分相关；（5）CD45(hi)/SS(hi)粒细胞上高水平的CD71表达与RARS类别相关。这些结果表明免疫表型异常与骨髓发育异常之间存在密切关系，并表明流式细胞术可能成为未来MDS特征化的工具。
