Kussick Steven J, Wood Brent L
University of Washington Department of Laboratory Medicine, Seattle, Wash, USA.
Arch Pathol Lab Med. 2003 Sep;127(9):1140-7. doi: 10.5858/2003-127-1140-UCFCTI.
The diagnosis of myeloproliferative disorders (MPDs) and myelodysplastic syndromes (MDSs) has historically relied on combining clinical information with the morphologic features of the peripheral blood and bone marrow to reach a final diagnosis. Objective evidence of a myeloid stem cell neoplasm in the form of a clonal cytogenetic abnormality is provided in only 30% to 40% of the non-chronic myeloid leukemia (CML) chronic MPDs (non-CML MPDs) and in a similar percentage of the MDSs.
To identify normal patterns of antigen expression during myeloid maturation and to determine whether flow cytometric evaluation of myeloid maturation represents an additional objective way to assess the likelihood of a stem cell neoplasm.
We retrospectively evaluated 4-color flow cytometry data from more than 400 bone marrow aspirates obtained since 1998 from patients suspected of having a non-CML MPD or an MDS.
Reproducible patterns of antigen expression were seen in normal myeloid maturation as well as in benign reactive settings such as marrow regeneration. In addition, we summarize data, presented in detail elsewhere, from a retrospective comparison of the sensitivity of flow cytometry with conventional cytogenetics for a large number of bone marrow aspirates on which both types of studies were performed. These data indicate that more than 90% of non-CML MPD and MDS cases with a clonal cytogenetic abnormality will be identified as abnormal by 4-color flow cytometry, and they therefore validate the use of flow cytometry in the diagnosis of these disorders.
In experienced laboratories, 4-color flow cytometry represents a valuable addition to the workup of non-CML MPDs and MDSs.
骨髓增殖性疾病（MPD）和骨髓增生异常综合征（MDS）的诊断历来依赖于将临床信息与外周血和骨髓的形态学特征相结合以得出最终诊断。仅30%至40%的非慢性粒细胞白血病（CML）慢性MPD（非CML MPD）以及相似比例的MDS中存在克隆性细胞遗传学异常形式的髓系干细胞肿瘤的客观证据。
识别髓系成熟过程中抗原表达的正常模式，并确定髓系成熟的流式细胞术评估是否代表评估干细胞肿瘤可能性的另一种客观方法。
我们回顾性评估了自1998年以来从疑似患有非CML MPD或MDS的患者中获取的400多份骨髓穿刺液的四色流式细胞术数据。
在正常髓系成熟以及骨髓再生等良性反应性情况下可观察到可重复的抗原表达模式。此外，我们总结了别处详细呈现的数据，这些数据来自对大量同时进行了流式细胞术和传统细胞遗传学研究的骨髓穿刺液进行的敏感性回顾性比较。这些数据表明，超过90%存在克隆性细胞遗传学异常的非CML MPD和MDS病例可通过四色流式细胞术被鉴定为异常，因此验证了流式细胞术在这些疾病诊断中的应用。
在经验丰富的实验室中，四色流式细胞术是对非CML MPD和MDS检查的一项有价值的补充。
