title: High flow cytometric scores identify adverse prognostic subgroups within the revised international prognostic scoring system for myelodysplastic syndromes.
abstract: The estimation of survival of myelodysplastic syndromes (MDS) and risk of progression into acute myeloid leukaemia is challenging due to the heterogeneous clinical course. The most widely used prognostic scoring system (International Prognostic Scoring System [IPSS]) was recently revised (IPSS-R). The aim of this study was to investigate the prognostic relevance of flow cytometry (FC) in the context of the IPSS-R. Bone marrow aspirates were analysed by FC in 159 patients with MDS. A flow score was calculated by applying the flow cytometric scoring system (FCSS). Patients were assigned to IPSS and IPSS-R risk groups. The FCSS correlated with the World Health Organization classification, IPSS and IPSS-R risk groups. Mild flow cytometric abnormalities were associated with significantly better overall survival (OS) and lower risk of disease evolution. The presence of aberrant myeloid progenitors was associated with transfusion dependency and disease progression. Most importantly, the FCSS identified prognostic subgroups within the IPSS-R cytogenetic good risk and low risk group. Flow cytometric analysis in patients with MDS provides additional prognostic information and is complementary to the IPSS-R. The addition of a flow cytometric score next to the clinical parameters within the IPSS-R is a further refinement of prognostication of patients with MDS.
authors: Department of Haematology, Cancer Centre Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands.
authors: Canan
authors: C
authors: Alhan
authors: Theresia M
authors: TM
authors: Westers
authors: Eline M P
authors: EM
authors: Cremers
authors: Claudia
authors: C
authors: Cali
authors: Birgit I
authors: BI
authors: Witte
authors: Gert J
authors: GJ
authors: Ossenkoppele
authors: Arjan A
authors: AA
authors: van de Loosdrecht
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001803:Blood Transfusion; D001853:Bone Marrow / Q000473:pathology; D001854:Bone Marrow Cells / Q000378:metabolism / Q000473:pathology; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D023461:Myeloid Progenitor Cells / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: IPSS-R; flow cytometry; myelodysplastic syndromes; prognosis