title: Prognostic relevance of the flow cytometric count of medullar blasts in myelodysplastic syndromes.
abstract: OBJECTIVE
  The medullar blast count is a milestone in the prognostic assessment in myelodysplastic syndromes (MDS). The optical microscopy (OM) may sometimes be inaccurate in this disease. The aim of this work is to test the flow immunocytometric (FCM) determinations of medullar immature cells (CD45(±) ) and the expression, among them, of CD33, CD34, and CD117 markers, for their prognostic relevance.
  
  
  METHODS
  In a retrospective analysis of 98 patients affected by MDS, the IPSS was re-calculated by means of the FCM determination of blasts. Survival of patients at low or intermediate-1 IPSS risk was compared with the survival of patients at intermediate-2 or high IPSS risk. In the 64 cases with OM blast count lower than 5%, the survival of patients with the FCM count of medullar blasts ≤2% was compared with that of patients with FCM count >2%.
  
  
  RESULTS
  Each single marker had a prognostic weight comparable to the optical blast count. The FCM blast count was particularly efficient in distinguishing the risk of having up to 2% or more than 2% of blasts in patients without OM excess of blasts.
  
  
  CONCLUSIONS
  This method is interesting as prognostic tool, especially in patients without excess of blast.
authors.affiliation: Department of Hematology, AO Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Molteni
authors.affiliation: Department of Hematology, AO Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Riva
authors.affiliation: Immuno-Hematology and Transfusional Unit, AO Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Clara
authors.initials: C
authors.lastname: Cesana
authors.affiliation: Department of General Medicine, AO Ospedale Civile di Legnano, Legnano, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Speziale
authors.affiliation: Service of Biostatistics Department of Hematology, AO Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Nichelatti
authors.affiliation: Immuno-Hematology and Transfusional Unit, AO Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Scarpati
authors.affiliation: Department of Hematology, AO Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Greco
authors.affiliation: Department of Hematology, AO Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Ravano
authors.affiliation: Department of General Medicine, Oncology and Hematology, Ospedale Valduce, Como, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cairoli
authors.affiliation: Immuno-Hematology and Transfusional Unit, AO Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Silvano
authors.initials: S
authors.lastname: Rossini
authors.affiliation: Department of Hematology, AO Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Enrica
authors.initials: E
authors.lastname: Morra
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001853:Bone Marrow / Q000473:pathology*; D001854:Bone Marrow Cells / Q000378:metabolism / Q000473:pathology*; D001856:Bone Marrow Examination; D002452:Cell Count; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis
chemical_list: D015415:Biomarkers
keywords: flow cytometry; medullar blasts count; myelodysplastic syndromes; prognostic assessment