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Database-guided Flow-cytometry for Evaluation of Bone Marrow Myeloid Cell Maturation
Published on: November 3, 2018
Flow cytometry immunophenotypic analysis of Philadelphia-negative myeloproliferative neoplasms: Correlation with
Juan Ouyang1, Wenli Zheng, Qi Shen
1Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
Insights
Flow cytometry immunophenotyping (FCI) reveals frequent immunophenotypic alterations in myelodysplastic syndromes (MPN), particularly in advanced disease stages. These findings support FCI
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Flow cytometry immunophenotyping (FCI) is established for myelodysplastic syndromes (MDS) diagnosis.
- Immunophenotypic alterations in myeloproliferative neoplasms (MPN) are less understood.
- The diagnostic and monitoring utility of FCI in MPN requires definition.
Purpose of the Study:
- To investigate the prevalence and characteristics of immunophenotypic alterations in Philadelphia-negative MPN.
- To compare FCI findings between MPN subtypes and with MDS.
- To assess the correlation of FCI abnormalities with MPN disease features and progression.
Main Methods:
- Multicolor FCI was performed on bone marrow samples from 83 MPN patients (ET, PV, PMF, MPN-U).
- Comparison group included 95 age-matched MDS patients with similar blast counts.
- Analysis focused on CD34+ cells and myelomonocytic cells for immunophenotypic abnormalities.
Main Results:
- 99% of MPN cases exhibited immunophenotypic alterations in CD34+ or myelomonocytic cells.
- FCI abnormalities were more frequent in MPN with substantial myelofibrosis, increased blasts, or abnormal karyotype.
- MPN cases showed less pronounced FCI abnormalities compared to MDS cases (p=0.001).
Conclusions:
- MPN cases frequently display immunophenotypic alterations, correlating with adverse histopathologic features and disease stage.
- FCI abnormalities are integral to the MPN disease profile.
- FCI holds potential for MPN diagnosis and monitoring disease progression and therapeutic response.
Abstract:
Background: Compared with the proven utility of flow cytometry immunophenotyping (FCI) analysis in the workup of myelodysplastic syndromes (MDS), immunophenotypic alterations in myeloproliferative neoplasms (MPN) have been less studied and the potential utility of FCI is not defined. Methods: Bone marrow (BM) samples of 83 Philadelphia-negative MPN patients were assessed by multicolor FCI including 27 with essential thrombocythemia (ET); 17 polycythemia vera (PV); 33 primary myelofibrosis (PMF) and 6 MPN-unclassifiable (MPN-U). The time interval from initial diagnosis of MPN to FCI analysis was 18 months (0-370). Ninety-five age-matched MDS patients with a similar BM blast count were included for comparison. Results: Immunophenotypic alterations, either in CD34+ cells or myelomonocytic cells, were detected in 82 of 83 (99%) MPN cases. FCI abnormalities were more frequently observed in cases with substantial myelofibrosis but not different between PMF and fibrotic stage of ET/PV. Furthermore, FCI abnormalities were more frequent in cases with ≥5% BM blasts and/or circulating blasts (p=0.006); as well as cases with an abnormal karyotype (p=0.036); but not associated with morphologic dysplasia or JAK2 mutation status. Comparing with MDS, FCI abnormalities were overall less pronounced in MPN cases (p=0.001). Conclusions: MPNs exhibit frequent immunophenotypic alterations, more pronounced in cases with adverse histopathologic features. These findings illustrate that immunophenotypic alterations are a part of constellational findings in MPN, and correlate progressively with disease stage. The study results also suggest a role of FCI in diagnosis of MPN and monitoring disease over time and after therapy. This article is protected by copyright. All rights reserved.
