Bone marrow cells from myelodysplastic syndromes show altered immunophenotypic profiles that may contribute to the diagnosis and prognostic stratification of the disease: a pilot study on a series of 56 patients.
A heterogeneous spectrum of immunophenotypic abnormalities have been reported in myelodysplastic syndromes (MDS). However, most studies are restricted to the analysis of CD34(+) cells and/or other major subsets of CD34(-) cells, frequently not exploring the diagnostic and prognostic impact of immunophenotyping.


METHODS
We propose for the first time an immunophenotypic score (IS) based on the altered distribution and immunophenotypic features of maturing/mature compartments of bone marrow (BM) hematopoietic cells in 56 patients with MDS that could contribute to a refined diagnosis and prognostic evaluation of the disease.


RESULTS
Although MDS-associated phenotypes were detected in reactive BM, the overall immunophenotypic profile of BM cells allowed an efficient discrimination between MDS and both normal and reactive BM, once the number and degree of severity of the abnormalities detected per patient were simultaneously considered in the proposed IS. Interestingly, increasingly higher IS were found among patients with MDS showing adverse prognostic factors and in low- versus high-grade cases. The most informative prognostic factors included the number of CD34(+) cells, presence of aberrant CD34(-)/CD117(+) precursors, decreased mature neutrophils and CD34(-) erythroid precursors, and increased numbers of CD36(-/lo) erythroid precursors; in addition, the IS was an independent prognostic factor for overall survival.


CONCLUSIONS
Assessment of immunophenotypic abnormalities of maturing/mature BM cells allows an efficient discrimination between MDS and both normal and reactive BM, once the number and degree of severity of the abnormalities detected are simultaneously scored. Interestingly, progressively higher IS were found among patients with MDS with adverse prognostic features and shorter overall survival.
Matarraz
Sergio
S
Centro de Investigación del Cáncer (Instituto de Biología Molecular y Celular del Cáncer; CSIC-USAL), Servicio General de Citometría and Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain.
López
Antonio
A
Barrena
Susana
S
Fernandez
Carlos
C
Jensen
Evan
E
Flores-Montero
Juan
J
Rasillo
Ana
A
Sayagues
José María
JM
Sánchez
Maria Luz
ML
Bárcena
Paloma
P
Hernandez-Rivas
Jesús María
JM
Salvador
Carlos
C
Fernandez-Mosteirín
Nuria
N
Giralt
Manuel
M
Perdiguer
Luis
L
Laranjeira
Paula
P
Paiva
Artur
A
Orfao
Alberto
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000276:immunology; D001854:Bone Marrow Cells / Q000276:immunology* / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000145:classification / Q000175:diagnosis* / Q000276:immunology* / Q000473:pathology; D010865:Pilot Projects; D011379:Prognosis
D015703:Antigens, CD