The myelodysplastic syndromes flow cytometric score: a three-parameter prognostic flow cytometric scoring system.
The prognosis of myelodysplastic syndromes (MDS) is currently estimated by using the revised International Prognostic Scoring System (IPSS-R). Several studies have shown that further refinement of prognostication for MDS can be achieved by adding flow cytometric parameters. However, widespread implementation of flow cytometry for the prognosis of MDS is hampered by complexity of the analysis. Therefore, the aim of this study was to construct a robust and practical flow cytometric score that could be implemented as a routine procedure. To achieve this, bone marrow aspirates of 109 MDS patients were analyzed by flow cytometry. A second cohort consisting of 103 MDS patients was used to validate the MDS flow cytometric score (MFS). The parameters forming the MFS were sideward light scatter and CD117 expression of myeloid progenitor cells and CD13 expression on monocytes. Three MFS risk categories were formed. Patients with MDS and intermediate MFS scores had significantly better overall survival (OS) compared with the patients with high MFS scores. The MFS further refined prognostication within the IPSS-R low-risk category, by identifying patients with worse OS in case of high MFS. In conclusion, a practical three parameter flow cytometric prognostic score was constructed enabling further refinement of prognostication of MDS.
Department of Hematology, Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands.
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C
Alhan
Department of Hematology, Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands.
T M
TM
Westers
Department of Hematology, Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands.
E M P
EM
Cremers
Department of Hematology, Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands.
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C
Cali
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
B I
BI
Witte
Department of Hematology, Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands.
G J
GJ
Ossenkoppele
Department of Hematology, Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands.
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AA
van de Loosdrecht
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001854:Bone Marrow Cells / Q000378:metabolism* / Q000473:pathology; D018826:CD13 Antigens / Q000235:genetics / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D005434:Flow Cytometry / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D015870:Gene Expression; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000235:genetics / Q000401:mortality / Q000473:pathology; D023461:Myeloid Progenitor Cells / Q000378:metabolism* / Q000473:pathology; D011379:Prognosis; D019009:Proto-Oncogene Proteins c-kit / Q000235:genetics / Q000378:metabolism; D012107:Research Design; D012307:Risk Factors; D016019:Survival Analysis
D019009:Proto-Oncogene Proteins c-kit; D018826:CD13 Antigens