DIAGNOSTIC UTILITY OF FLOW CYTOMETRY IN MYELODYSPLASTIC SYNDROMES.

Abstract

The pathological hallmark of myelodysplastic syndromes (MDS) is marrow dysplasia, which representsthe basis of the WHO classi?cation of these disorders. This classi?cation provides clinicians with a useful tool for de?ning the different subtypes of MDS and individual prognosis. The WHO proposal has raised some concern regarding minimal diagnostic criteria particularly in patients with normal karyotype without robust morphological markers of dysplasia (such as ring sideroblasts or excess of blasts). Therefore, there is clearly a need to re?ne the accuracy to detect marrow dysplasia. Flow cytometry (FCM) immunophenotyping has been proposed as a tool to improve the evaluation of marrow dysplasia. Rationale for the application of FCM in the diagnostic work up of MDS is that immunophenotyping is an accurate method for quantitative and qualitative evaluation of hematopoietic cells and that MDS have been found to have abnormal expression of several cellular antigens. To become clinically applicable, FCM analysis should be based on parameters with suf?cient speci?city and sensitivity, data should be reproducible between different operators and the results should be easily understood by clinicians. In this review, we discuss the most relevant progresses in detection of marrow dysplasia by FCM in MDS