TY - JOUR
T1 - Flow cytometry immunophenotypic findings in chronic myelomonocytic leukemia and its utility in monitoring treatment response
AU - Shen, Qi
AU - Ouyang, Juan
AU - Tang, Guilin
AU - Jabbour, Elias J.
AU - Garcia-Manero, Guillermo
AU - Routbort, Mark
AU - Konoplev, Sergej
AU - Bueso-Ramos, Carlos
AU - Medeiros, L. Jeffrey
AU - Jorgensen, Jeffrey L.
AU - Wang, Sa A.
N1 - Publisher Copyright:
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - 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.
AB - 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.
KW - CD34
KW - Chronic myelomonocytic leukemia
KW - Flow cytometry
KW - Hypomethylating agent
KW - Non-specific esterase
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U2 - 10.1111/ejh.12477
DO - 10.1111/ejh.12477
M3 - Article
C2 - 25354960
AN - SCOPUS:84935718116
SN - 0902-4441
VL - 95
SP - 168
EP - 176
JO - European Journal of Haematology
JF - European Journal of Haematology
IS - 2
ER -