Korean J Lab Med.  2010 Apr;30(2):97-104. 10.3343/kjlm.2010.30.2.97.

Immunophenotypic Features of Granulocytes, Monocytes, and Blasts in Myelodysplastic Syndromes

• Moon HW
• Huh JW
• Lee M
• Hong KS
• Chung WS

• KMID: 1096792
• DOI: http://doi.org/10.3343/kjlm.2010.30.2.97

Abstract

BACKGROUND
Despite the diagnostic utility of immunophenotyping for myelodysplastic syndromes (MDS), it has not been widely performed, and reports on this are absent in Korea. We aimed to evaluate the immunophenotypic features of non-blastic granulocytes, monocytes, and blasts in patients with MDS and non-clonal disorders using routine flow cytometry (FCM). Moreover, we evaluated the phenotypic abnormalities of mature cells in leukemic patients.
METHODS
Marrow aspirates from 60 patients, including 18 with MDS, 18 with leukemia, and 24 with non-clonal disorders (control group), were analyzed using FCM. Blasts, non-blast myeloid cells, and monocytes were gated based on CD45 expression and side scatter (SSC). The phenotypes were then compared among the 3 groups.
RESULTS
Compared to non-clonal disorders, the granulocytic lineages of MDS showed decreased SSC (P=0.005), increased CD45 intensity (P=0.020), decreased CD10-positive granulocytes (P= 0.030), and a higher CD56-positive rate (P=0.005). It is noteworthy that similar results were obtained in the leukemia group, and these findings were not related to the phenotypes of the leukemic cells. Using blast and monocytic gating, useful parameters for generating a differential diagnosis were not found.
CONCLUSIONS
Gating the granulocytic region is a relatively easy method for MDS immunophenotyping. Among the parameters studied, SSC, CD10, and CD56 were the most useful for differentiating MDS from non-clonal disorders. While immunophenotypic changes in MDS appear to be useful for differentiating MDS from non-clonal disorders, these changes were also noted in the mature cells of leukemic patients.

Keyword

Immunophenotyping; MDS; Granulocyte; Monocyte; Blast

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Antigens, CD45/metabolism
Antigens, CD56/metabolism
Bone Marrow Cells/cytology
Cell Lineage
Child
Child, Preschool
Diagnosis, Differential
Female
Flow Cytometry
Granulocytes/*classification
Humans
*Immunophenotyping
Leukemia/diagnosis/pathology
Male
Middle Aged
Monocytes/*classification
Myelodysplastic Syndromes/*diagnosis
Neprilysin/metabolism
Phenotype

Figure

• 

  Fig. 1. Flow cytometric gating of bone marrow cells: Gating of sub-populations were based on CD45 intensities and side scatter (S-SC). Blasts (A, CD45intermediateSSClow), granulocytes (B, CD45intermediate SSChigh), and monocytes (C, CD45highSSClow-intermediate).

• 

  Fig. 2. The distributions of granulocyte SSC in non-clonal disorders (A), MDS (B), and leukemia (C). Compared to non-clonal disorders, granulocyte SSC was significantly lower in the MDS and leukemia groups (P=0.005 and 0.000, respectively). Values are mean±2 SD of the SSC in each group. Abbreviation: SSC, side scatter.

• 

  Fig. 3. Examples of immunophenotypes of granulocytes in MDS (A) and non-clonal disorders (B). In a patient with MDS, decreased SSC, absence of the CD10-positive population, and CD56 expression were noted (A) whereas CD10-positive cells were present, and CD56 was not expressed in patients with non-clonal disorders (B). Abbreviation: SSC, side scatter.

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