骨髓增生异常综合征中髓系原始细胞流式细胞术计数的预后相关性
Prognostic relevance of the flow cytometric count of medullar blasts in myelodysplastic syndromes.
作者信息
Molteni Alfredo, Riva Marta, Cesana Clara, Speziale Valentina, Nichelatti Michele, Scarpati Barbara, Greco Rosa, Ravano Emanuele, Cairoli Roberto, Rossini Silvano, Morra Enrica
机构信息
Department of Hematology, AO Ospedale Niguarda Ca' Granda, Milan, Italy.
Immuno-Hematology and Transfusional Unit, AO Ospedale Niguarda Ca' Granda, Milan, Italy.
出版信息
Eur J Haematol. 2015 Jun;94(6):519-25. doi: 10.1111/ejh.12465. Epub 2014 Dec 4.
OBJECTIVE
The medullar blast count is a milestone in the prognostic assessment in myelodysplastic syndromes (MDS). The optical microscopy (OM) may sometimes be inaccurate in this disease. The aim of this work is to test the flow immunocytometric (FCM) determinations of medullar immature cells (CD45(±) ) and the expression, among them, of CD33, CD34, and CD117 markers, for their prognostic relevance.
METHODS
In a retrospective analysis of 98 patients affected by MDS, the IPSS was re-calculated by means of the FCM determination of blasts. Survival of patients at low or intermediate-1 IPSS risk was compared with the survival of patients at intermediate-2 or high IPSS risk. In the 64 cases with OM blast count lower than 5%, the survival of patients with the FCM count of medullar blasts ≤2% was compared with that of patients with FCM count >2%.
RESULTS
Each single marker had a prognostic weight comparable to the optical blast count. The FCM blast count was particularly efficient in distinguishing the risk of having up to 2% or more than 2% of blasts in patients without OM excess of blasts.
CONCLUSION
This method is interesting as prognostic tool, especially in patients without excess of blast.
目的
髓系原始细胞计数是骨髓增生异常综合征（MDS）预后评估中的一个里程碑。光学显微镜检查（OM）在这种疾病中有时可能不准确。本研究的目的是检测流式免疫细胞术（FCM）对骨髓未成熟细胞（CD45(±)）的测定以及其中CD33、CD34和CD117标志物的表达，以评估其预后相关性。
方法
在对98例MDS患者的回顾性分析中，通过FCM测定原始细胞重新计算国际预后评分系统（IPSS）。比较低或中-1 IPSS风险患者与中-2或高IPSS风险患者的生存率。在64例OM原始细胞计数低于5%的病例中，比较骨髓原始细胞FCM计数≤2%的患者与FCM计数>2%的患者的生存率。
结果
每个单一标志物的预后权重与光学原始细胞计数相当。在没有OM原始细胞过多的患者中，FCM原始细胞计数在区分原始细胞比例高达2%或超过2%的风险方面特别有效。
结论
作为一种预后工具，这种方法很有意义，尤其是在没有原始细胞过多的患者中。
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