A Multiparametric Flow Cytometry Immunophenotypic Scoring System for the Diagnosis and Prognosis of Myelodysplastic Syndromes

Abstract

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