title: Multiparameter flow cytometry reveals myelodysplasia-related aberrant antigen expression in myelodysplastic/myeloproliferative neoplasms.
abstract: BACKGROUND
  Within the myelodysplastic/myeloproliferative neoplasm (MDS/MPN) category of the WHO (2008), only chronic myelomonocytic leukemia was so far evaluated by multiparameter flow cytometry (MFC).
  
  
  METHODS
  To investigate the potential of MFC for MDS/MPNs, unclassifiable (MDS/MPNu), and refractory anemia associated with ring sideroblasts and marked thrombocytosis (RARS-T), we studied 91 patients with these entities (60 males/31 females; 35.3-87.4 years) for MDS-related aberrant immunophenotypes (≥ 2 different cell lineages with ≥ 3 aberrantly expressed antigens). Data were correlated with cytomorphology and cytogenetics.
  
  
  RESULTS
  MFC identified MDS-related immunophenotypes in 54/91 (59.3%) of patients. Patients with or without MDS-related immunophenotype did not differ significantly by demographic characteristics, blood values, or median overall survival. MDS-related immunophenotype cases showed a higher number of aberrantly expressed antigens (mean ± SD, 4.9 ± 2.4 vs. 2.0 ± 1.4; P < 0.001). Aberrant karyotypes showed a similar frequency in patients with and without MDS-related immunophenotype (11/54; 20.4% vs. 7/37; 18.9%; P = n.s.).
  
  
  CONCLUSIONS
  MDS-related immunophenotype are present in more than half of patients with MDS/MPNu and RARS-T. MFC therefore may be helpful to separate cases into more "MDS-like" or "MPN-like" subgroups.
authors.affiliation: MLL Munich Leukemia Laboratory, Munich 81377, Germany. wolfgang.kern@mll.com
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kern
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bacher
authors.forename: Susanne
authors.initials: S
authors.lastname: Schnittger
authors.forename: Tamara
authors.initials: T
authors.lastname: Alpermann
authors.forename: Claudia
authors.initials: C
authors.lastname: Haferlach
authors.forename: Torsten
authors.initials: T
authors.lastname: Haferlach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000753:Anemia, Refractory / Q000175:diagnosis* / Q000235:genetics / Q000401:mortality / Q000473:pathology; D000756:Anemia, Sideroblastic / Q000175:diagnosis* / Q000235:genetics / Q000401:mortality / Q000473:pathology; D015703:Antigens, CD / Q000235:genetics* / Q000276:immunology; D020732:Cytogenetic Analysis; D003937:Diagnosis, Differential; D041905:Erythroid Cells / Q000276:immunology / Q000473:pathology; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D015870:Gene Expression; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000235:genetics / Q000401:mortality / Q000473:pathology; D022423:Myeloid Cells / Q000276:immunology / Q000473:pathology; D009196:Myeloproliferative Disorders / Q000175:diagnosis* / Q000235:genetics / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis
chemical_list: D015703:Antigens, CD