Aires Ana, Teixeira Maria Dos Anjos, Lau Catarina, Moreira Cláudia, Spínola Ana, Mota Alexandra, Freitas Inês, Coutinho Jorge, Lima Margarida
1Department of Hematology, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Porto, Portugal.
3Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS/UP), Porto, Portugal.
BMC Hematol. 2018 Mar 13;18:6. doi: 10.1186/s12878-018-0101-8. eCollection 2018.
Immunophenotypic analysis of the bone marrow (BM) cells has proven to be helpful in the diagnosis of Myelodysplastic Syndromes (MDS). However, the usefulness of flow cytometry (FCM) for the detection of myelodysplasia in the peripheral blood (PB) still needs to be investigated. The aim of this pilot study was to evaluate the value of FCM-based PB neutrophil and monocyte immunophenotyping for the diagnosis of lower risk MDS (LR-MDS).
We evaluated by 8-color FCM the expression of multiple cell surface molecules (CD10, CD11b, CD11c, CD13, CD14, CD15, CD16, CD34, CD45, CD56, CD64 and HLA-DR) in PB neutrophils and monocytes from a series of 14 adult LR-MDS patients versus 14 normal individuals.
Peripheral blood neutrophils from patients with LR-MDS frequently had low forward scatter (FSC) and side scatter (SSC) values and low levels of CD11b, CD11c, CD10, CD16, CD13 and CD45 expression, in that order, as compared to normal neutrophils. In addition, patients with LR-MDS commonly display a higher fraction of CD14CD56 and a lower fraction of CD14CD16 monocytes in the PB. Based on these results, we proposed an immunophenotyping score based on which PB samples from patients with LR-MDS could be distinguished from normal PB samples with a sensitivity 93% and a specificity of 100%. In addition, we used this score to construct the MDS Thermometer, a screening tool for detection and monitoring of MDS in the PB in clinical practice.
Peripheral blood neutrophil and monocyte immunophenotyping provide useful information for the diagnosis of LR-MDS, as a complement to cytomorphology. If validated by subsequent studies in larger series of MDS patients and extended to non-MDS patients with cytopenias, our findings may improve the diagnostic assessment and avoid invasive procedures in selected groups of MDS patients.
骨髓（BM）细胞的免疫表型分析已被证明有助于骨髓增生异常综合征（MDS）的诊断。然而，流式细胞术（FCM）在外周血（PB）中检测骨髓发育异常的实用性仍有待研究。本初步研究的目的是评估基于FCM的PB中性粒细胞和单核细胞免疫表型分析对低危MDS（LR-MDS）诊断的价值。
我们通过8色FCM评估了14例成年LR-MDS患者与14例正常个体的PB中性粒细胞和单核细胞中多种细胞表面分子（CD10、CD11b、CD11c、CD13、CD14、CD15、CD16、CD34、CD45、CD56、CD64和HLA-DR）的表达。
与正常中性粒细胞相比，LR-MDS患者的外周血中性粒细胞通常依次具有低前向散射（FSC）和侧向散射（SSC）值以及低水平的CD11b、CD11c、CD10、CD16、CD13和CD45表达。此外，LR-MDS患者的PB中通常显示出较高比例的CD14CD56单核细胞和较低比例的CD14CD16单核细胞。基于这些结果，我们提出了一种免疫表型评分，据此可将LR-MDS患者的PB样本与正常PB样本区分开来，灵敏度为93%，特异性为100%。此外，我们使用该评分构建了MDS温度计，这是一种在临床实践中用于检测和监测PB中MDS的筛查工具。
外周血中性粒细胞和单核细胞免疫表型分析可为LR-MDS的诊断提供有用信息，作为细胞形态学的补充。如果后续在更大系列的MDS患者中进行研究验证并扩展到血细胞减少的非MDS患者，我们的发现可能会改善诊断评估并避免对部分MDS患者进行侵入性检查。
