Wells Denise A, Benesch Martin, Loken Michael R, Vallejo Carlos, Myerson David, Leisenring Wendy M, Deeg H Joachim
Hematologics, Inc., 113 1st Avenue N, Seattle, WA 98109, USA.
Blood. 2003 Jul 1;102(1):394-403. doi: 10.1182/blood-2002-09-2768. Epub 2003 Mar 20.
Marrow cells of myeloid lineage from 115 patients with myelodysplastic syndrome (MDS) were characterized by multidimensional flow cytometry and compared with findings in 104 patients with various disorders and 25 healthy donors. Based on phenotypic and scatter characteristics, a flow cytometric scoring system (FCSS) was developed that allowed for a simple numerical display of results. The flow cytometric scores were categorized as normal/mild (0-1), moderate (2-3), or severe (> or = 4). Most flow cytometric abnormalities were significantly (P <.05) more frequent in patients with MDS than in the control cohort. Flow cytometric scores in MDS patients were then retrospectively compared with marrow blast counts assessed by morphology, cytogenetics, hematologic parameters, and International Prognostic Scoring System (IPSS) risk categorization. The flow cytometric scores correlated inversely with leukocyte and absolute neutrophil counts (P <.01) and correlated directly with IPSS scores (P <.01) and with IPSS cytogenetic risk categories (P <.01). In 111 MDS patients who underwent allogeneic hematopoietic stem cell transplantation, flow scores correlated with posttransplantation outcome. The probabilities of posttransplantation relapse were 3%, 15%, and 33% for patients with mild, moderate, and severe FCSS scores, respectively (P <.01), and overall survival was 74%, 40%, and 36%, respectively, for the 3 groups (P <.01). In multivariate analyses, there was a significant contribution of the flow score independent of the IPSS in predicting survival and relapse (P <.01, P =.02, and P =.03, respectively). These data suggest that FCSS is useful in assessing marrows for diagnosis of MDS and in determining the prognostic outcome in patients with this disorder.
采用多参数流式细胞术对115例骨髓增生异常综合征（MDS）患者的髓系谱系骨髓细胞进行特征分析，并与104例患有各种疾病的患者及25名健康供者的结果进行比较。基于表型和散射特征，开发了一种流式细胞术评分系统（FCSS），可对结果进行简单的数值显示。流式细胞术评分分为正常/轻度（0 - 1）、中度（2 - 3）或重度（≥4）。大多数流式细胞术异常在MDS患者中出现的频率显著高于对照组（P <.05）。然后对MDS患者的流式细胞术评分与通过形态学、细胞遗传学、血液学参数及国际预后评分系统（IPSS）风险分类评估的骨髓原始细胞计数进行回顾性比较。流式细胞术评分与白细胞和绝对中性粒细胞计数呈负相关（P <.01），与IPSS评分（P <.01）及IPSS细胞遗传学风险分类呈正相关（P <.01）。在111例接受异基因造血干细胞移植的MDS患者中，流式评分与移植后结局相关。FCSS评分为轻度、中度和重度的患者移植后复发概率分别为3%、15%和33%（P <.01），三组患者的总生存率分别为74%、40%和36%（P <.01）。在多变量分析中，流式评分在预测生存和复发方面独立于IPSS有显著贡献（分别为P <.01、P =.02和P =.03）。这些数据表明，FCSS有助于评估骨髓用于MDS的诊断，并有助于确定该疾病患者的预后结局。
