A multiparametric flow cytometry immunophenotypic scoring system for the diagnosis and prognosis of myelodysplastic syndromes.

BACKGROUND: Myelodysplastic syndromes (MDS) are a group of clonal stem/progenitor cell diseases. The diagnosis of MDS, especially in the early stages, represents a particular challenge. Therefore, this study aimed to develop a multiparametric flow cytometry (FCM) method to analyze the immunophenotypic characteristics of MDS patients and establish a FCM scoring system to evaluate its potential for the diagnosis, classification, and prognosis of MDS.

METHODS: 41 bone marrow samples from MDS patients and 30 bone marrow samples from non-MDS patients were subjected to multiparametric flow cytometry. ROC curve and Spearman's correlation analysis were performed to combine the results of hematology, morphology, and cytogenetic analyses of these samples.

RESULTS: Based on the proportion of blasts and the expression of antigens on cell populations, we established a BM FCM scoring system. The system has a good correlation rate (p = 0.006) for MDS diagnosis; the 95% confidence interval was 0.921 - 0.997 and the sensitivity and specificity were 90.2% and 86.7%, respectively. The BM FCM scores of the MDS group was significantly higher than the non-MDS group (p = 0.008). Moreover, there were positive correlations between FCM scores and MDS classification, karyotype, and IPSS and WPSS scores.

CONCLUSIONS: We have established a BM FCM scoring system that may provide a useful adjunct to existing tests for accurate diagnosis and prognosis of MDS.