The Role of Flow Cytometric Immunophenotyping in Myelodysplastic Syndromes

The myelodysplastic syndromes (MDSs) are a group of heterogeneous hematological disorders characterized by bilineage or trilineage dysplastic morphology, abnormal clonal populations, progressive bone marrow failure, and a high rate of transformation to acute myeloid leukemia. A combination of morphology, to detect multilineage dysplasia in the bone marrow and peripheral blood, and cytogenetics to detect characteristic clonal abnormalities, is used in establishing a diagnosis of MDS. Although diagnostic criteria are well established, a significant number of patients have blood and bone marrow findings that make diagnosis and classification difficult. Flow cytometric immunophenotyping is an accurate and highly sensitive method for quantitative and qualitative evaluation of hematopoietic cells in the different maturative compartments, and several groups have used flow cytometry in the study of MDSs. Findings of recent studies suggest that flow cytometry immunophenotyping might provide useful information in the diagnosis and the management of MDS patients.