title: Value of Quantitative assessment of Myeloid Nuclear Differentiation Antigen expression and other flow cytometric parameters in the diagnosis of Myelodysplastic syndrome.
abstract: BACKGROUND
  The diagnosis of myelodysplastic syndrome (MDS) based on morphology is particularly difficult in low-grade MDS. Thus, the role of myeloid nuclear differentiation antigen (MNDA) and other flow cytometric (FCM) parameters in MDS was evaluated.
  
  
  METHODS
  Bone marrow aspirates (BMA) collected from 52 patients with unexplained persistent cytopenias were divided into three groups: (i) proven MDS (n = 12) based on morphology and/or cytogenetics; (ii) suspected MDS (n = 6), noncontributory morphology, and cytogenetics; and (iii) non-MDS (n = 34). Sixteen control BMA were studied. Cases were analyzed for MNDA expression (on granulocytes, blasts, monocytes, and lymphocytes) and for seven quantitative parameters: CD34(+) myeloblasts % in nucleated cells, CD34(+) B-cell progenitor% in CD34(+) cells, lymphocyte/myeloblast CD45 MFI ratio, granulocyte/lymphocyte SSC peak channel ratio and the proportion of CD34(+) myeloblasts expressing CD15, CD11b, and CD56. A score of 1 was given to each parameter beyond the cutoff, and score ≥3 was considered FCM positive.
  
  
  RESULTS
  MNDA expression on granulocytes and blasts was significantly lower in proven MDS and suspected MDS vs. non-MDS. Quantitative FCM parameters successfully distinguished MDS and suspected MDS from non-MDS.
  
  
  CONCLUSIONS
  MNDA expression is an independent marker for the evaluation of dyspoiesis and may be added to the standard panel for quantitative assessment by FCM.
authors.affiliation: Department of Haematology, IRCH, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: V
authors.initials: V
authors.lastname: Somasundaram
authors.affiliation: Department of Laboratory Oncology, IRCH, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Soni
authors.affiliation: Department of Laboratory Oncology, IRCH, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Chopra
authors.affiliation: Department of Laboratory Oncology, IRCH, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Rai
authors.affiliation: Department of Haematology, IRCH, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: M
authors.initials: M
authors.lastname: Mahapatra
authors.affiliation: Department of Laboratory Oncology, IRCH, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: R
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Haematology, IRCH, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: H
authors.initials: H
authors.lastname: Pati
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism*; D015415:Biomarkers; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D001854:Bone Marrow Cells / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000378:metabolism*; D012372:ROC Curve; D014157:Transcription Factors / Q000378:metabolism*
chemical_list: D015214:Antigens, Differentiation, Myelomonocytic; D015415:Biomarkers; C075373:MNDA protein, human; D014157:Transcription Factors
keywords: Flow cytometry; Myelodysplastic syndrome; Myeloid nuclear differentiation antigen