Side scatter ratio of the CD105-positive and CD105-negative red blood cell fractions is useful for the detection of low-grade myelodysplastic neoplasms by flow cytometry

Zijan Wang; Pedro C Ciarlini; Kwadwo A Oduro; Ramya Gadde; Stacey O'Neill; Chen Zhao; Howard J Meyerson

doi:10.1093/ajcp/aqae021

Side scatter ratio of the CD105-positive and CD105-negative red blood cell fractions is useful for the detection of low-grade myelodysplastic neoplasms by flow cytometry

Am J Clin Pathol. 2024 Apr 6:aqae021. doi: 10.1093/ajcp/aqae021. Online ahead of print.

Authors

Zijan Wang¹, Pedro C Ciarlini¹, Kwadwo A Oduro¹, Ramya Gadde¹, Stacey O'Neill¹, Chen Zhao¹, Howard J Meyerson¹

Affiliation

¹ Department of Pathology, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH, US.

PMID: 38581145
DOI: 10.1093/ajcp/aqae021

Abstract

Objectives: We assessed the utility of red blood cell (RBC) CD105 and side scatter (SSC) parameters by flow cytometry for the detection of low-grade myelodysplastic neoplasms (MDS) in bone marrow specimens.

Methods: Ten RBC parameters incorporating CD105 or SSC combined with the Meyerson-Alayed scoring system (MASS) metrics were retrospectively evaluated by flow cytometry for utility in detecting low-grade MDS (n = 56) compared with cytopenic controls (n = 86).

Results: Myelodysplastic neoplasms were associated with 7 of the RBC parameters in univariate analysis. Multivariate analysis using cutoff values based on optimal and 95% specificity levels of the RBC metrics and the MASS parameters revealed the SSC ratio of CD105-positive and CD105-negative RBC fractions (CD105+/- SSC); the percentage and coefficient of variation of the CD105-positive fraction of RBCs (CD105%, CD105+CV) emerged as significant RBC variables. Two simple scoring schemes using these RBC values along with MASS parameters were identified: 1 using CD105+/- SSC, CD105%, and CD105+CV combined with the percentage of CD177-positive granulocytes (CD177%), myeloblast percentage (CD34%), and granulocyte SSC (GranSSC), and the other incorporating CD105+/- SSC, CD105+CV, CD177%, CD34%, GranSSC, and B-cell progenitor percentage. Both demonstrated a sensitivity of approximately 80%, with a specificity of roughly 90% for the detection of MDS compared with cytopenic controls.

Conclusions: The red blood cell parameter, CD105+/- SSC, appears to be beneficial in the evaluation of low-grade MDS by flow cytometry.

Keywords: CD105; erythroid; flow cytometry; myelodysplastic neoplasm; side scatter.

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