Division of Hematopathology, Mayo Clinic, Rochester, MN, USA.
Division of Hematology, Mayo Clinic, Rochester, MN, USA.
Am J Clin Pathol. 2022 Oct 6;158(4):530-536. doi: 10.1093/ajcp/aqac083.
Patients with clonal cytopenia of undetermined significance (CCUS) are at increased risk of developing myeloid neoplasia (MN). We evaluated whether a simple flow cytometry immunophenotyping (FCIP) assay could differentiate the risk of development of MN in patients with CCUS.
Bone marrow aspirates were assessed by FCIP panel in a cohort of 80 patients identified as having CCUS based on next-generation sequencing or cytogenetics from March 2015 to May 2020, with available samples. Flow cytometric assay included CD13/HLA-DR expression pattern on CD34-positive myeloblasts; CD13/CD16 pattern on maturing granulocytic precursors; and aberrant expression of CD2, CD7, or CD56 on CD34-positive myeloblasts. Relevant demographic, comorbidity, and clinical and laboratory data, including the type and extent of genetic abnormalities, were extracted from the electronic health record.
In total, 17 (21%) patients with CCUS developed MN over the follow-up period (median survival follow-up, 28 months [95% confidence interval, 19-31]). Flow cytometry immunophenotyping abnormalities, including the aberrant pattern of CD13/HLA-DR expression, as detected at the time of the diagnosis of CCUS, were significantly associated with risk of developing MN (hazard ratio, 2.97; P = .006). Additional FCIP parameters associated with the development of MN included abnormal expression of CD7 on myeloblasts and the presence vs absence of any FCIP abnormality.
A simple FCIP approach that includes assessment of CD13/HLA-DR pattern on CD34-positive myeloblasts can be useful in identifying patients with CCUS at higher risk of developing MN.
具有未确定意义的克隆性血细胞减少症（CCUS）的患者发生髓系肿瘤（MN）的风险增加。我们评估了一种简单的流式细胞免疫表型（FCIP）检测是否可以区分 CCUS 患者发生 MN 的风险。
根据 2015 年 3 月至 2020 年 5 月基于下一代测序或细胞遗传学确定的 CCUS 患者队列，对 80 例患者的骨髓抽吸物进行 FCIP 检测，这些患者有可用样本。流式细胞术检测包括 CD34 阳性原始细胞上 CD13/HLA-DR 表达模式；成熟粒细胞前体上 CD13/CD16 模式；CD34 阳性原始细胞上 CD2、CD7 或 CD56 的异常表达。从电子病历中提取相关的人口统计学、合并症和临床及实验室数据，包括遗传异常的类型和程度。
在随访期间，共有 17 例（21%）CCUS 患者发生 MN（中位随访生存时间为 28 个月[95%置信区间，19-31]）。在诊断 CCUS 时检测到的 FCIP 异常，包括 CD13/HLA-DR 表达异常模式，与发生 MN 的风险显著相关（风险比，2.97；P =.006）。与 MN 发生相关的其他 FCIP 参数包括原始细胞上 CD7 的异常表达以及 FCIP 异常的存在与否。
一种简单的 FCIP 方法，包括评估 CD34 阳性原始细胞上 CD13/HLA-DR 模式，可用于识别发生 MN 风险较高的 CCUS 患者。
