Flow cytometry immunophenotyping has been suggested as an adjunctive technique in the evaluation of myeloid malignancies, especially in the myelodysplastic syndromes. Its use, however, has been limited due to complexity and cost restraints.
A recent study by Mayo Clinic in the American Journal of Clinical Pathology, first author Dragan Jevremovic, M.D., Ph.D., was completed to attempt a simpler approach to flow cytometry immunophenotyping in myeloid neoplasms.
Upon analyzing bone marrow specimens of 45 selected patients and an additional 99 consecutive random patients using a limited antibody panel, the study found that normal CD34-positive blasts show a characteristic pattern of CD13/HLA-DR expression, with three readily identifiable subpopulations. In contrast, myeloid neoplasms frequently show loss of this heterogeneity.
The image to the left shows the distinction between normal and abnormal blast expression pattern of CD13/HLA-DR. A, Three normal bone marrow specimens. B, Three bone marrow specimens from patients treated with granulocyte colony-stimulating factor. C, Three bone marrow specimens from patients with myelodysplastic syndrome and less than 5% blasts.
Based on this study, analysis of a limited antibody panel with a focus on CD13/HLA-DR expression provides relatively high specificity and sensitivity for the detection of myeloid neoplasms.
Additional Mayo Clinic authors include: Michael Timm, Kaaren Reichard, M.D., William Morice, M.D., Ph.D., Curtis Hanson, M.D., David Viswanatha, M.D., Matthew Howard, M.D., and Phuong Nguyen, M.D.