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Updated: Apr 19, 2026
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 Ouyang1,2, Wenli Zheng1,3, Qi Shen1
1Department of Hematopathology, the University of Texas MD Anderson Cancer Center, Houston, Texas.
Insights
Flow cytometry immunophenotyping (FCI) detects frequent alterations in myeloproliferative neoplasms (MPN), particularly with advanced disease features. FCI aids in diagnosing MPN and monitoring disease progression and treatment response.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Flow cytometry immunophenotyping (FCI) is established for myelodysplastic syndromes (MDS) but understudied in myeloproliferative neoplasms (MPN).
- The diagnostic and prognostic utility of FCI in MPN remains largely undefined.
Purpose of the Study:
- To investigate the frequency and characteristics of immunophenotypic alterations in Philadelphia-negative MPN using multicolor FCI.
- To compare FCI findings in MPN with those in MDS.
Main Methods:
- Multicolor FCI was performed on bone marrow samples from 83 MPN patients (ET, PV, PMF, MPN-U) and 95 age-matched MDS patients.
- Analysis focused on CD34(+) cells and myelomonocytic cells, correlating findings with clinical and histopathologic features.
Main Results:
- 99% of MPN cases showed immunophenotypic alterations via FCI.
- Abnormalities were more frequent in MPN with myelofibrosis, ≥5% bone marrow blasts, and abnormal karyotype.
- FCI abnormalities were less pronounced in MPN compared to MDS.
Conclusions:
- MPN frequently exhibit immunophenotypic alterations, correlating with adverse histopathologic features and disease stage.
- FCI shows potential utility in MPN diagnosis and disease monitoring over time and after therapy.
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.
