An increased percentage of myeloid CD34+ bone marrow cells stratifies intermediate IPSS-R myelodysplastic syndrome patients into prognostically significant groups
| Autor: | Ma Luz Amigo, A. M. Casado-Prieto, María-Dolores García-Malo, Andres Jerez, Tzu Hua Chen-Liang, Francisco José Ortuño, V. Campos-Rodríguez, Ana María Hurtado, Vicente Vicente |
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| Rok vydání: | 2017 |
| Předmět: |
Oncology
medicine.medical_specialty Prognostic variable Myeloid business.industry Myelodysplastic syndromes Biochemistry (medical) Clinical Biochemistry CD34 Myeloid leukemia Hematology General Medicine medicine.disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure International Prognostic Scoring System 030220 oncology & carcinogenesis Internal medicine Cytology medicine Bone marrow business 030215 immunology |
| Zdroj: | International journal of laboratory hematologyREFERENCES. 40(5) |
| ISSN: | 1751-553X |
| Popis: | INTRODUCTION The Revised International Prognostic Scoring System (IPSS-R) for myelodysplastic syndromes (MDS) has established an intermediate category where a disease-modifying intervention is a matter of debate. Flow cytometry allows us to determine a fraction of immature myeloid cells in a semiautomated procedure. The aim of this study, mirroring IPSS-R study inclusion criteria, was to test whether bone marrow (BM) CD34+My percentage has independent prognostic value in the MDS setting. METHODS BM CD34+My cells were quantified, at diagnosis, selecting CD34+/CD45+/CD11b±/CD13+. Patients were excluded when receiving treatment for altering the natural course of the disease and when IPSS-R could not be calculated due to the lack of metaphases. Finally, Cox analyses were performed, on a series of 260 patients, for overall survival (OS) and time to acute myeloid leukemia (AML) transformation. RESULTS By analyzing ROC curves, the most accurate prognostic variable, regarding blasts by cytology and CD34+ by cytometry, was the percentage of blasts by microscopy. The percentage of CD34+My in BM showed an AUC of 0.767 and 0.576 for time to AML transformation and OS, respectively. When performing a multivariate regression including the IPSS-R and the percentage of BM CD34+My cells >1%, both factors predicted for a shorter time to AML transformation. In addition, CD34+My percentage successfully stratified the intermediate IPSS-R category into two prognostic groups with a relative risk of 5.73 (95% CI [1.2-27.8]; P = .03). CONCLUSION We found that BM CD34+My percentage has an independent value concerning the IPSS-R, especially relevant for the prediction of transformation to AML and within the intermediate group. |
| Databáze: | OpenAIRE |
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