RT Journal Article
SR Electronic
T1 Flow cytometric analysis of neutrophil myeloperoxidase expression in peripheral blood for ruling out myelodysplastic syndromes: a diagnostic accuracy study
JF Haematologica
JO Haematologica
FD Ferrata Storti Foundation
SP 2382
OP 2390
DO 10.3324/haematol.2018.202275
VO 104
IS 12
A1 Raskovalova, Tatiana
A1 Berger, Marc G.
A1 Jacob, Marie-Christine
A1 Park, Sophie
A1 Campos, Lydia
A1 Aanei, Carmen Mariana
A1 Kasprzak, Julie
A1 Pereira, Bruno
A1 Labarère, José
A1 Cesbron, Jean-Yves
A1 Veyrat-Masson, Richard
YR 2019
UL http://www.haematologica.org/content/104/12/2382.abstract
AB Suspicion of myelodysplastic syndromes (MDS) is one of the commonest reasons for bone marrow aspirate in elderly patients presenting with persistent peripheral blood (PB) cytopenia of unclear etiology. A PB assay that accurately rules out MDS would have major benefits. The diagnostic accuracy of the intra-individual robust coefficient of variation (RCV) for neutrophil myeloperoxidase (MPO) expression measured by flow cytometric analysis in PB was evaluated in a retrospective derivation study (44 MDS cases and 44 controls) and a prospective validation study (68 consecutive patients with suspected MDS). Compared with controls, MDS cases had higher median RCV values for neutrophil MPO expression (40.2% vs. 30.9%; P<0.001). The area under the receiver operating characteristic curve estimates were 0.94 [95% confidence interval (CI): 0.86-0.97] and 0.87 (95%CI: 0.76-0.94) in the derivation and validation studies, respectively. A RCV lower than 30% ruled out MDS with 100% sensitivity (95%CI: 78-100%) and 100% negative predictive value (95%CI: 83-100%) in the prospective validation study. Neutrophil MPO expression measured by flow cytometric analysis in PB might obviate the need for invasive bone marrow aspirate and biopsy for up to 29% of patients with suspected MDS.