The Immunophenotype Analysis Of Low-risk Myelodysplastic Syndrome

ObjectiveThis study was aimed to detect quantitative analysis CD34~+and immune-ophenotypes of low-risk myelodysplastic syndrome(MDS) bone marrow cells inorder to probe into their clinical significance to MDS’s diagnosis, differentialdiagnosis and prognosis.MethodsWe acquired0.2milliliter(ml) bone marrow aspirate respectively to surveymorphology from patients of Low-risk MDS27cases, AA12cases and18healthy volunteers(the health control) by routine bone marrow puncture. Afterthat，we acquired another marrow aspriate3ml placed in EDTA-anticoagulationtube for FCM, then3ml bone marrow aspriate laied up to Low-risk MDS27cases for genetics test. All the patients had signed informed consent. A panel ofmonoclonal antibodies, direct immunofluorescence and the flow cytometry usingCD45/SCC gating strategies was used for the immuno phenotyping on the bonemarrow nucleated cells from the patients with low-risk MDS. Meanwhile, we tookthe quantitative data compaired with the controls and the AA patients.Results1. Our study revealed abnormal immune phenotype expressed in higherincidence of multiple expression abnormal of primitive cell, mature granulocyte,and mononuclear leucocyte in low-risk MDS patients.2. It was high expression of CD34~+in low-risk MDS patients’ primitive cells（p<0.05）and its exprission trend is to be higher with the classification risk(from RA/RAS, RCMD to RAEB-1, higher and higher). But there were not signifiancebetween the RA/RAS group and the control(p﹥0.05). We also observedcrossing cells express of CD34~+.3. It was signifiant lower trend of CD34~+cells in AA group patients, andthere were significant differences between AA group and the low-risk MDS, thecontrol（p<0.05）.Conclusion1. The expressing of CD34~+cells were heightened in low-risk MDSaccompanying abnormal expressing of CD34~+cells. This demonstrated therewere high express of hematopoietic stem/progenitor cells and heterogeneity inMDS, and it suggested abnormal cloning were contained in hematopoieticstem/progenitor cells of MDS. Granulocyte-mononuclear cells lack of specificitywith a high incidence of abnorma express, so granulocyte-mononuclear cellswere helpful to the diagnosis of MDS.2. The express of CD34~+cells were increased gradually(with the trendfrom RA/RAS, RCMD to RAEB-1) with the number of the bone marrowpathological hematopoietic lineages and primitive cells in low-risk MDS patients.This showed the low-risk MDS bone marrow morphology was correlated withthe express of hematopoietic stem/progenitor cells in FCM. Moreover, theexpress level of CD34~+cells and the CD7expressed across lineages werecontrabuted to the prognosis of MDS.3. The express of CD34~+cells were lower in AA group, and there wassignifant difference compared with the control or the low-risk MDS(p<0.05).This showed FCM was helpful to the differential diagnosis of AA and low-riskMDS.