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Type: Artigo de periódico
Title: Improving The Differential Diagnosis Between Myelodysplastic Syndromes And Reactive Peripheral Cytopenias By Multiparametric Flow Cytometry: The Role Of B-cell Precursors.
Author: Reis-Alves, Suiellen C
Traina, Fabiola
Metze, Konradin
Lorand-Metze, Irene
Abstract: Immunophenotyping is a valuable ancillary technique for the differential diagnosis between myelodysplastic syndromes (MDS) with low bone marrow (BM) blast counts and a normal karyotype, and reactive peripheral (PB) cytopenias. Our aim was to search for the most important variables for this purpose. We also analyzed the age variation of BM B-cell precursors (BCP) and its differences in reactive and clonal cytopenias. Immunophenotypic analyzes were performed in BM of 54 patients with MDS (76% with BM blasts <5%) and 35 cases of reactive cytopenias. Healthy allogeneic BM transplantation donors (n = 41) were used as controls. We used a four-color panel of antibodies analyzing 9 granulocytic, 8 monocytic and 6 CD34(+) cell features. Asynchronous shift to the left in maturing granulocytes and increase in CD16(+) monocytes were also found in reactive PB cytopenias, but the most important aberrancies in MDS were seen in myeloid CD34(+) cells. Decrease in BCP, that is a hallmark of MDS, could also be found in reactive cytopenias, especially in patients >55 years. % BM BCP could be calculated by the formula: (-7.97 × log age) + (4.24 × log % CD34 (+) cells) - (0.22 x nr. alterations CD34 (+) cells) + 0.577. Corrected R(2) = 0.467. Analysis of myelomonocytic precursors and CD34(+) cells was satisfactory for the differential diagnosis between reactive PB cytopenias and MDS. The most specific alterations were found in CD34(+) cells. Comparison of the values obtained with those of normal age-matched controls is recommended. The virtual slide(s) for this article can be found here:
Subject: Adolescent
Age Factors
Aged, 80 And Over
Antigens, Cd34
Case-control Studies
Diagnosis, Differential
Flow Cytometry
Lymphocyte Count
Middle Aged
Myelodysplastic Syndromes
Precursor Cells, B-lymphoid
Predictive Value Of Tests
Young Adult
Citation: Diagnostic Pathology. v. 10, p. 44, 2015.
Rights: aberto
Identifier DOI: 10.1186/s13000-015-0259-3
Date Issue: 2015
Appears in Collections:Unicamp - Artigos e Outros Documentos

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