Flow cytometry immunophenotypic findings in chronic myelomonocytic leukemia and its utility in monitoring treatment response.

Abstract:

:Chronic myelomonocytic leukemia (CMML) is a myelodysplastic/myeloproliferative neoplasm, characterized by persistent monocytosis. Due to the lack of unique surface markers expressed by neoplastic monocytes and the frequent CD34-negative blast immunophenotype, the diagnostic value of flow cytometric immunophenotyping (FCI) in CMML is rarely studied. In this study, by using a multicolor FCI assay, we assessed bone marrow (BM) immunophenotypical alterations in 118 CMML patients and follow-up BM samples in 35 of these patients. The median BM monocytes as determined by FCI were 14% (1-63%), correlated with morphologic count (P = 0.0004). FCI alterations in monocytes were observed in 96% and granulocytes in 83% of cases. The percentage of CD34(+) myeloblasts by FCI was low [median 0.6% (0.02-12.6%)], but exhibiting frequent aberrancies [median 6 (2-12)]. CD34(+) B-cell precursors were absent in 93% of cases. In 35 patients with follow-up BM samples assessed, the CD34(+) myeloblasts showed persistent FCI aberrancies in all 29 patients treated with hypomethylating agents and 3 patients on observation, but became normal in 3 patients following stem cell transplant. In conclusion, CMML exhibit numerous FCI alterations in monocytes, granulocytes, and more profound/frequent in CD34(+) myeloblasts. These findings provide solid evidence for using FCI as an ancillary test in CMML diagnosis and also, in assessment of treatment responses.

journal_name

Eur J Haematol

authors

Shen Q,Ouyang J,Tang G,Jabbour EJ,Garcia-Manero G,Routbort M,Konoplev S,Bueso-Ramos C,Medeiros LJ,Jorgensen JL,Wang SA

doi

10.1111/ejh.12477

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

168-76

issue

2

eissn

0902-4441

issn

1600-0609

journal_volume

95

pub_type

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