Application of Flow Cytometry, Fluorescent In-Situ Hybridization and Cytogenetics in Diagnosis of Myelodysplastic Syndrome
Peilin Zhang, Darren Harris, Richard Fulks, Sylvia T Zhang, Angel Cinco. St. Francis Hospital, Thomas Healthcare System, Charleston, WV
Background: Cytopenia and myelodysplastic syndrome often present a diagnostic problem, and the distinction between cytopenia due to systemic medical conditions and cytopenia due to bone marrow failure is important for clinical management of these patients. It is often difficult to distinguish true MDS from cytopenia of other causes without application of ancillary tests such as flow cytometry, FISH and cytogenetics.
Design: We attempt to use the flow cytometry, FISH and conventional cytogenetics to sort out the true MDS patients presented with cytopenia. We have reviewed 105 bone marrows specimens from cytopenic patients with complete data of flow cytometry, FISH and cytogenetics from 2007-2010. We have analyzed flow cytometry data and compared the results of FISH and cytogenetics since our results are performed at the single commercial reference laboratory.
Results: All studies were performed at the commercial reference laboratory. The flow cytometry study is useful in analysis of myelodysplastic syndrome by demonstrating the lineage specific dysplastic features. No specific markers of bone marrow elements can be reliably dependent upon to differentiate MDS due to the marrow failure from those of other causes. CD10 expression of myeloid precursors is of limited use in diagnosis of MDS. We found that there are 11 FISH abnormalities (out of 105 bone marrow biopsies), and 13 cytogenetic abnormalities within these patients (12.4%). The abnormality rate identified by FISH is slightly lower than that by cytogenetics. There were two cases with normal cytogenetic results whereas FISH study showed deletion of 20q in both cases. There were 3 cases with normal FISH analyses but cytogenetic study showed deletion 11q, deletion 18 and t(9:22). There were three cases of complex cytogenetic results, and only some of these cytogenetic changes were identified by FISH study.
Conclusions: Based on our data with FISH and cytogenetics in diagnosis of MDS, we felt that each of the flow cytometry, FISH and cytogenetic study has its own merit in assessment of bone marrow biopsy specimens in MDS patients, and the combination of all these tests will probably provide better pathologic evaluation of MDS.
Tuesday, March 20, 2012 9:30 AM
Poster Session III # 229, Tuesday Morning