Department of Oncology/Hematology, Buddhist Tzu Chi General Hospital, Institute of Medical Sciences, College of Medicine, Department of Medicine, Tzu-Chi University, Hualien, Taiwan.
Leuk Res. 2011 Jul;35(7):868-73. doi: 10.1016/j.leukres.2011.02.016. Epub 2011 Mar 12.
The aim of this study is to validate the clinical utility of the flow cytometric scoring system (FCSS), quantifying phenotypic aberrancies in the myelomonocytic lineages, in the diagnosis and prognosis for conventionally treated myelodysplastic syndromes (MDS) patients. The bone marrow samples from 56 consecutive newly diagnosed MDS patients were characterized by the FCSS and compared with findings in 27 non-MDS cytopenic patients. The FCSS scores were significantly higher in patients with MDS than those in the non-MDS control. A flow score of 2 or more allowed for a specificity of 100% with 75% sensitivity in distinguishing these two groups. The FCSS scores correlated directly with validated prognostic systems including WHO classification, International Prognostic Scoring System (IPSS), WHO-adjusted prognostic scoring system (WPSS) and transfusion dependency. The median survival of conventionally treated MDS patients was directly related to FCSS group; severe: 6 months; moderate: 19 months and normal/mild: not reached. The multivariate analyses suggested the FCSS risk categories were an independent prognostic factor after adjustment for sex, age (above or below 70 years), IPSS or WPSS risk categories. These results confirm that quantifying aberrancies in the myelomonocytic lineage by FCSS is useful in MDS diagnosis and extends the prognostic utility for conventionally treated/untreated patients, especially among patients classified within the refractory cytopenia with multilineage dysplasia (RCMD) subgroup.
本研究旨在验证流式细胞术评分系统（FCSS）的临床实用性，该系统可量化骨髓髓系前体细胞的表型异常，用于诊断和预测传统治疗的骨髓增生异常综合征（MDS）患者的预后。对 56 例新诊断的 MDS 患者的骨髓样本进行了 FCSS 特征分析，并与 27 例非 MDS 血细胞减少症患者的结果进行了比较。MDS 患者的 FCSS 评分明显高于非 MDS 对照组。FCSS 评分≥2 分可特异性为 100%，敏感性为 75%，可区分这两组。FCSS 评分与包括 WHO 分类、国际预后评分系统（IPSS）、WHO 调整预后评分系统（WPSS）和输血依赖性在内的验证性预后系统直接相关。传统治疗的 MDS 患者的中位生存期与 FCSS 组直接相关；严重组为 6 个月；中度组为 19 个月；正常/轻度组未达到。多变量分析表明，在调整性别、年龄（＞70 岁或＜70 岁）、IPSS 或 WPSS 风险类别后，FCSS 风险类别是独立的预后因素。这些结果证实，通过 FCSS 定量评估骨髓髓系前体细胞的异常在 MDS 的诊断中是有用的，并扩展了传统治疗/未治疗患者的预后实用性，尤其是在难治性血细胞减少伴多系发育异常（RCMD）亚组患者中。
