VALUE OF THE MULTIPARAMETRIC FLOW CYTOMETRY IN LOW RISK MYELODYSPLASTIC SYNDROMES AND TYPE I CHRONIC MYELOMONOCYTIC LEUKEMIA
(Abstract release date: 05/19/16)
EHA Library. Iastrebner M. 06/09/16; 132774; E1225
Dr. Marcelo Iastrebner
Contributions
Contributions
Abstract
Abstract: E1225
Type: Eposter Presentation
Background
Heterogeneity in Low Risk Myelodysplastic Syndromes (MDS) and Type I Chronic Myelomonocytic Leukemia (CMML) is very remarkable and demands a maximum expertise to establish the diagnosis and prognosis. Multiparametric Flow Cytometry (MFC) should allow physicians to systematize and standardize this assessment.
Aims
To analyze, by using MFC, the value of the immunophenotypic changes in Low Risk MDS and type I CMML patients.
Methods
This retrospective study included low risk MDS and type I CMML adult patients (pts) at diagnosis, and used FAB, WHO, and IPSS classifications. An eight-color MFC and a specific MDS panel validated by Euroflow with Infinicyt ® program were applied. Granulocytic maturation is classified into 3 groups according to precise stops or blocking maturation observed in myeloblasts (Mbl) (stage 1), in promyelocytes (Pro) and metamyelocytes (MT) (stage 2), and without any blocking or Neutrophil (N) (stage 3): Stage 1 (Mbl) Stage 2 (Pro+MT) Stage 3 (N) > 3,5% or > 2,8% + > Stage 2 > 48% with < stage I > 58,5% with < stage 2 Blasts (CD34), erythroid, monocyte (Mo), and mast cells count (>0,04), aberrance and blocking maturation were taken into account. Peripheral cytopenia, cytogenetic, AML progression, and mortality rate were also studied. Informed consent was obtained.
Results
Sixty-six pts with low risk primary MDS (n=49) and CMML (n=17) were assessed. Median age 71 (R 21-89), male/female gender: 37/29, WHO classification: RCMDRS (1), RCMD (37), 5q- (2), RARS (1), RA (4), RAEB-1 (5) and type I CMML (17). AML progression: 15%; mortality rate: 30%, and causes of death: infections (35%), AML (40%), comorbidities (20%) and second tumor (5%). Sixty-two pts were evaluable for blocking granulocytic maturation and were divided into 3 groups: stage 1 (20), stage 2 (16) and stage 3 (26). Stage 1: (20 pts), 31.3% (CD34+ 1.92; range: 0.14-6.59), overall survival: 34 months (median), p=0,001 and, stage 2 and 3 were p=ns. Progression to AML was similar among all groups (p=ns). CMML patients had an increased blocking maturation in promonocyte stage (p=0,05), but not showed difference in mature monocytes (p=ns). Excluding CMML pts, we found that immature monocyte group (< 56%) was significantly associated with thrombocytopenia (p=0,038), without any incidence over other cytopenia and cytogenetic abnormalities (p=ns). The overall survival was decreased with mast cells count ≥0.04 (with a median of 34 months; p=0.04), independently of the staging maturation group. Erythroid Aberrancies did not show higher transfusion requirement rate (p=0,5).
Conclusion
MFC in low risk MDS and type I CMML proved to be objective and reproducible by standards. Immature monocyte in MDS group correlated with thrombocytopenia (p=0,038). Short overall survival was associated with high mast cells count (p=0.04) and early granulocyte stages blocking maturation (p=0,001).
Session topic: E-poster
Keyword(s): Cytometry, Mast cell, MDS
Type: Eposter Presentation
Background
Heterogeneity in Low Risk Myelodysplastic Syndromes (MDS) and Type I Chronic Myelomonocytic Leukemia (CMML) is very remarkable and demands a maximum expertise to establish the diagnosis and prognosis. Multiparametric Flow Cytometry (MFC) should allow physicians to systematize and standardize this assessment.
Aims
To analyze, by using MFC, the value of the immunophenotypic changes in Low Risk MDS and type I CMML patients.
Methods
This retrospective study included low risk MDS and type I CMML adult patients (pts) at diagnosis, and used FAB, WHO, and IPSS classifications. An eight-color MFC and a specific MDS panel validated by Euroflow with Infinicyt ® program were applied. Granulocytic maturation is classified into 3 groups according to precise stops or blocking maturation observed in myeloblasts (Mbl) (stage 1), in promyelocytes (Pro) and metamyelocytes (MT) (stage 2), and without any blocking or Neutrophil (N) (stage 3): Stage 1 (Mbl) Stage 2 (Pro+MT) Stage 3 (N) > 3,5% or > 2,8% + > Stage 2 > 48% with < stage I > 58,5% with < stage 2 Blasts (CD34), erythroid, monocyte (Mo), and mast cells count (>0,04), aberrance and blocking maturation were taken into account. Peripheral cytopenia, cytogenetic, AML progression, and mortality rate were also studied. Informed consent was obtained.
Results
Sixty-six pts with low risk primary MDS (n=49) and CMML (n=17) were assessed. Median age 71 (R 21-89), male/female gender: 37/29, WHO classification: RCMDRS (1), RCMD (37), 5q- (2), RARS (1), RA (4), RAEB-1 (5) and type I CMML (17). AML progression: 15%; mortality rate: 30%, and causes of death: infections (35%), AML (40%), comorbidities (20%) and second tumor (5%). Sixty-two pts were evaluable for blocking granulocytic maturation and were divided into 3 groups: stage 1 (20), stage 2 (16) and stage 3 (26). Stage 1: (20 pts), 31.3% (CD34+ 1.92; range: 0.14-6.59), overall survival: 34 months (median), p=0,001 and, stage 2 and 3 were p=ns. Progression to AML was similar among all groups (p=ns). CMML patients had an increased blocking maturation in promonocyte stage (p=0,05), but not showed difference in mature monocytes (p=ns). Excluding CMML pts, we found that immature monocyte group (< 56%) was significantly associated with thrombocytopenia (p=0,038), without any incidence over other cytopenia and cytogenetic abnormalities (p=ns). The overall survival was decreased with mast cells count ≥0.04 (with a median of 34 months; p=0.04), independently of the staging maturation group. Erythroid Aberrancies did not show higher transfusion requirement rate (p=0,5).
Conclusion
MFC in low risk MDS and type I CMML proved to be objective and reproducible by standards. Immature monocyte in MDS group correlated with thrombocytopenia (p=0,038). Short overall survival was associated with high mast cells count (p=0.04) and early granulocyte stages blocking maturation (p=0,001).
Session topic: E-poster
Keyword(s): Cytometry, Mast cell, MDS
Abstract: E1225
Type: Eposter Presentation
Background
Heterogeneity in Low Risk Myelodysplastic Syndromes (MDS) and Type I Chronic Myelomonocytic Leukemia (CMML) is very remarkable and demands a maximum expertise to establish the diagnosis and prognosis. Multiparametric Flow Cytometry (MFC) should allow physicians to systematize and standardize this assessment.
Aims
To analyze, by using MFC, the value of the immunophenotypic changes in Low Risk MDS and type I CMML patients.
Methods
This retrospective study included low risk MDS and type I CMML adult patients (pts) at diagnosis, and used FAB, WHO, and IPSS classifications. An eight-color MFC and a specific MDS panel validated by Euroflow with Infinicyt ® program were applied. Granulocytic maturation is classified into 3 groups according to precise stops or blocking maturation observed in myeloblasts (Mbl) (stage 1), in promyelocytes (Pro) and metamyelocytes (MT) (stage 2), and without any blocking or Neutrophil (N) (stage 3): Stage 1 (Mbl) Stage 2 (Pro+MT) Stage 3 (N) > 3,5% or > 2,8% + > Stage 2 > 48% with < stage I > 58,5% with < stage 2 Blasts (CD34), erythroid, monocyte (Mo), and mast cells count (>0,04), aberrance and blocking maturation were taken into account. Peripheral cytopenia, cytogenetic, AML progression, and mortality rate were also studied. Informed consent was obtained.
Results
Sixty-six pts with low risk primary MDS (n=49) and CMML (n=17) were assessed. Median age 71 (R 21-89), male/female gender: 37/29, WHO classification: RCMDRS (1), RCMD (37), 5q- (2), RARS (1), RA (4), RAEB-1 (5) and type I CMML (17). AML progression: 15%; mortality rate: 30%, and causes of death: infections (35%), AML (40%), comorbidities (20%) and second tumor (5%). Sixty-two pts were evaluable for blocking granulocytic maturation and were divided into 3 groups: stage 1 (20), stage 2 (16) and stage 3 (26). Stage 1: (20 pts), 31.3% (CD34+ 1.92; range: 0.14-6.59), overall survival: 34 months (median), p=0,001 and, stage 2 and 3 were p=ns. Progression to AML was similar among all groups (p=ns). CMML patients had an increased blocking maturation in promonocyte stage (p=0,05), but not showed difference in mature monocytes (p=ns). Excluding CMML pts, we found that immature monocyte group (< 56%) was significantly associated with thrombocytopenia (p=0,038), without any incidence over other cytopenia and cytogenetic abnormalities (p=ns). The overall survival was decreased with mast cells count ≥0.04 (with a median of 34 months; p=0.04), independently of the staging maturation group. Erythroid Aberrancies did not show higher transfusion requirement rate (p=0,5).
Conclusion
MFC in low risk MDS and type I CMML proved to be objective and reproducible by standards. Immature monocyte in MDS group correlated with thrombocytopenia (p=0,038). Short overall survival was associated with high mast cells count (p=0.04) and early granulocyte stages blocking maturation (p=0,001).
Session topic: E-poster
Keyword(s): Cytometry, Mast cell, MDS
Type: Eposter Presentation
Background
Heterogeneity in Low Risk Myelodysplastic Syndromes (MDS) and Type I Chronic Myelomonocytic Leukemia (CMML) is very remarkable and demands a maximum expertise to establish the diagnosis and prognosis. Multiparametric Flow Cytometry (MFC) should allow physicians to systematize and standardize this assessment.
Aims
To analyze, by using MFC, the value of the immunophenotypic changes in Low Risk MDS and type I CMML patients.
Methods
This retrospective study included low risk MDS and type I CMML adult patients (pts) at diagnosis, and used FAB, WHO, and IPSS classifications. An eight-color MFC and a specific MDS panel validated by Euroflow with Infinicyt ® program were applied. Granulocytic maturation is classified into 3 groups according to precise stops or blocking maturation observed in myeloblasts (Mbl) (stage 1), in promyelocytes (Pro) and metamyelocytes (MT) (stage 2), and without any blocking or Neutrophil (N) (stage 3): Stage 1 (Mbl) Stage 2 (Pro+MT) Stage 3 (N) > 3,5% or > 2,8% + > Stage 2 > 48% with < stage I > 58,5% with < stage 2 Blasts (CD34), erythroid, monocyte (Mo), and mast cells count (>0,04), aberrance and blocking maturation were taken into account. Peripheral cytopenia, cytogenetic, AML progression, and mortality rate were also studied. Informed consent was obtained.
Results
Sixty-six pts with low risk primary MDS (n=49) and CMML (n=17) were assessed. Median age 71 (R 21-89), male/female gender: 37/29, WHO classification: RCMDRS (1), RCMD (37), 5q- (2), RARS (1), RA (4), RAEB-1 (5) and type I CMML (17). AML progression: 15%; mortality rate: 30%, and causes of death: infections (35%), AML (40%), comorbidities (20%) and second tumor (5%). Sixty-two pts were evaluable for blocking granulocytic maturation and were divided into 3 groups: stage 1 (20), stage 2 (16) and stage 3 (26). Stage 1: (20 pts), 31.3% (CD34+ 1.92; range: 0.14-6.59), overall survival: 34 months (median), p=0,001 and, stage 2 and 3 were p=ns. Progression to AML was similar among all groups (p=ns). CMML patients had an increased blocking maturation in promonocyte stage (p=0,05), but not showed difference in mature monocytes (p=ns). Excluding CMML pts, we found that immature monocyte group (< 56%) was significantly associated with thrombocytopenia (p=0,038), without any incidence over other cytopenia and cytogenetic abnormalities (p=ns). The overall survival was decreased with mast cells count ≥0.04 (with a median of 34 months; p=0.04), independently of the staging maturation group. Erythroid Aberrancies did not show higher transfusion requirement rate (p=0,5).
Conclusion
MFC in low risk MDS and type I CMML proved to be objective and reproducible by standards. Immature monocyte in MDS group correlated with thrombocytopenia (p=0,038). Short overall survival was associated with high mast cells count (p=0.04) and early granulocyte stages blocking maturation (p=0,001).
Session topic: E-poster
Keyword(s): Cytometry, Mast cell, MDS
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