Published online 22 June 2009
Haematologica, Vol 94, Issue 8, 1124-1134 doi:10.3324/haematol.2009.005801
Copyright © 2009 by Ferrata Storti Foundation

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by van de Loosdrecht, A. A. Articles by Westers, T. M. Search for Related Content PubMed PubMed Citation Articles by van de Loosdrecht, A. A. Articles by Westers, T. M. Related Collections Related Article

Myelodysplastic Syndromes

Standardization of flow cytometry in myelodysplastic syndromes: report from the first European LeukemiaNet working conference on flow cytometry in myelodysplastic syndromes

Arjan A. van de Loosdrecht¹, Canan Alhan¹, Marie Christine Béné², Matteo G. Della Porta³, Angelika M. Dräger¹, Jean Feuillard⁴, Patricia Font⁵, Ulrich Germing⁶, Detlef Haase⁷, Christa H. Homburg⁸, Robin Ireland⁹, Joop H. Jansen¹⁰, Wolfgang Kern¹¹, Luca Malcovati³, Jeroen G. te Marvelde¹², Ghulam J. Mufti⁹, Kiyoyuki Ogata¹³, Alberto Orfao¹⁴, Gert J. Ossenkoppele¹, Anna Porwit¹⁵, Frank W. Preijers¹⁰, Stephen J. Richards¹⁶, Gerrit Jan Schuurhuis¹, Dolores Subirá¹⁷, Peter Valent¹⁸, Vincent H.J. van der Velden¹², Paresh Vyas¹⁹, August H. Westra¹, Theo M. de Witte¹⁰, Denise A. Wells²⁰, Michael R. Loken²⁰, Theresia M. Westers¹

¹ Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
² Faculty of Medicine & CHU, Nancy Université, France
³ Department of Hematology and Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, and University of Pavia, Italy
⁴ Laboratoire d’Hématologie, CHU Dupuytren, Limoges, France
⁵ Department of Hematology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
⁶ Department of Hematology Oncology and Clinical Immunology, Heinrich-Heine-University, Düsseldorf, Germany
⁷ Department of Hematology and Oncology, Georg-August-University, Göttingen, Germany
⁸ Sanquin Research at CLB, Amsterdam, The Netherlands
⁹ King’s College Hospital, London, United Kingdom
¹⁰ Department of Hematology, St Radboud University Medical Center, Nijmegen, The Netherlands
¹¹ MLL Munich Leukemia Laboratory, Munich, Germany
¹² Department of Immunology, Erasmus MC, Rotterdam, The Netherlands
¹³ Division of Hematology, Department of Medicine, Nippon Medical School, Tokyo, Japan
¹⁴ Servicio Central de Citometría, Centro de Investigación del Cáncer, Instituto de Biologia Celular y Molecular del Cáncer (CSIC/USAL) and Department of Medicine, Universidad de Salamanca, Spain
¹⁵ Department of Pathology, Karolinska University Hospital, Stockholm, Sweden
¹⁶ HMDS, St. James’s University Hospital, Leeds, United Kingdom
¹⁷ Department of Hematology, Fundación Jiménez Díaz, Madrid, Spain
¹⁸ Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
¹⁹ Department of Hematology, Weatherall Institute of Molecular Medicine University of Oxford and John Radcliffe Hospital, Oxford, United Kingdom
²⁰ Hematologics, Inc., Seattle, WA, USA

Correspondence: Arjan A. van de Loosdrecht, MD, PhD, Department of Hematology, VU-Institute of Cancer and Immunology, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. E-mail:a.vandeloosdrecht{at}vumc.nl

The myelodysplastic syndromes are a group of clonal hematopoietic stem cell diseases characterized by cytopenia(s), dysplasia in one or more cell lineages and increased risk of evolution to acute myeloid leukemia (AML). Recent advances in immunophenotyping of hematopoietic progenitor and maturing cells in dysplastic bone marrow point to a useful role for multiparameter flow cytometry (FCM) in the diagnosis and prognostication of myelodysplastic syndromes. In March 2008, representatives from 18 European institutes participated in a European LeukemiaNet (ELN) workshop held in Amsterdam as a first step towards standardization of FCM in myelodysplastic syndromes. Consensus was reached regarding standard methods for cell sampling, handling and processing. The group also defined minimal combinations of antibodies to analyze aberrant immunophenotypes and thus dysplasia. Examples are altered numbers of CD34⁺ precursors, aberrant expression of markers on myeloblasts, maturing myeloid cells, monocytes or erythroid precursors and the expression of lineage infidelity markers. When applied in practice, aberrant FCM patterns correlate well with morphology, the subclassification of myelodysplastic syndromes, and prognostic scoring systems. However, the group also concluded that despite strong evidence for an impact of FCM in myelodysplastic syndromes, further (prospective) validation of markers and immunophenotypic patterns are required against control patient groups as well as further standardization in multi-center studies. Standardization of FCM in myelodysplastic syndromes may thus contribute to improved diagnosis and prognostication of myelodysplastic syndromes in the future.

Key words: myelodysplastic syndromes, flow cytometry, standardization, ELN, consensus.

Related Article

Flow cytometry immunophenotyping for diagnosis of myelodysplastic syndrome

Mario Cazzola
Haematologica 2009 94: 1041-1043. [Full Text] [PDF]

This article has been cited by other articles:

				B. Feng, S. Verstovsek, J. L. Jorgensen, and P. Lin Aberrant Myeloid Maturation Identified by Flow Cytometry in Primary Myelofibrosis Am J Clin Pathol, February 1, 2010; 133(2): 314 - 320. [Abstract] [Full Text] [PDF]

				M. Cazzola Flow cytometry immunophenotyping for diagnosis of myelodysplastic syndrome Haematologica, August 1, 2009; 94(8): 1041 - 1043. [Full Text] [PDF]