Publication Date:
2006-11-16
Description:
Background. Recent studies suggest that Flow Cytometry (FCM) might provide information useful in managing Myelodysplastic Syndromes (MDS) patients. Aim of the work. The purpose of this work is to describe the prognostic relevance of FCM analysis on a cohort of 303 myelodysplastic patients (64 RA; 15 RARS; 59 RCMD; 12 5q-MDS; 20 U-MDS, 72 RAEB-I, 44 RAEB-II, 17 LMMC), registered in the Multicenter Piedmont MDS Registry. Patients, materials, and methods. Marrow of 303 patients was studied by seven local FCM laboratories, using monoclonal antibodies against: CD3, CD8, CD4, CD16, CD19, CD34, CD117, CD33, CD14, CD11b, CD66b, HLADR, GPA and CD45. Myeloid maturation was evaluated according to the expression of both CD11b and CD66b antigens. Immature compartment of myeloblasts was analysed with CD117 and CD11b−CD66b−, and myeloid maturation with CD11b−CD66b+ (promyelocytes), CD11b+CD66b++ (myelocytes and metamyelocytes), CD11b+CD66b+ (neutrophils and bands). This definition of myeloid subpopulations was confirmed by sorting and by citospin. The overall survival (OS) and Leukemia-Free Survival (LFS) was calculated from the time of diagnosis until death or until leukaemia transformation. Survival curves were obtained by the Kaplan-Meier method and compared by the log-rank test. To evaluate the impact of FCM parameters on OS and LFS, we determined quantitative expression of the following antigen: CD117 and CD11b−CD66b− (≤5% vs 〉5%); CD11b−CD66b+ (≤12% vs 〉12%); CD11b+CD66b++ (≤15% vs 〉15%); CD11b+CD66b+ (≤25% vs 〉25%). Results. In our patients, quantitative expression of CD117 correlated with a shorter OS and LFS: the 40 months-OS was 66,5% versus 26,4% (p5% 71.5% vs 45.9% 0.0002 90.8% vs 51.3% 0.00001 CD11b−CD66b+ ≤12% vs 〉12% 49.8% vs 58.1% NS 80.7% vs 76.6% NS CD11b+CD66++ ≤15% vs 〉15% 33.0% vs 63.3% 0.001 58.9% vs 87.5% 0.002 CD11b+CD66b+ ≤25% vs 〉25% 30.3% vs 64.3% 0.00003 53.3% vs 76.6% 0.0008 Leukaemia transformation free Survival (Kaplan-Meier) ○ Complete + Censored Leukaemia transformation free Survival (Kaplan-Meier) ○ Complete + Censored
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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