DIAGNOSTIC APPLICATION AND CLINICAL SIGNIFICANCE OF FCM WELLS SCORING SYSTEM IN MYELODYSPLASTIC SYNDROMES

Objective: Myelodysplastic syndromes (MDS) are  group of clonal diseases of the hematopoietic system characterized by ineffective hematopoiesis,  dysmyelopoiesis, a high frequency karyotype abnormalities and the risk of transformation into acute leukemias. Cytopenic and dysplastic changes are not pa...

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Autores principales: Reyhan Aliyeva, Agarza Aghayev, Adam Najafli, Reyhan Tagizade, Azer Kerimov
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Publicado: Elsevier 2021
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spelling oai:doaj.org-article:cc6e7a3d9e1a48228ab9feac447ebd8a2021-11-10T04:33:39ZDIAGNOSTIC APPLICATION AND CLINICAL SIGNIFICANCE OF FCM WELLS SCORING SYSTEM IN MYELODYSPLASTIC SYNDROMES2531-137910.1016/j.htct.2021.10.995https://doaj.org/article/cc6e7a3d9e1a48228ab9feac447ebd8a2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2531137921011421https://doaj.org/toc/2531-1379Objective: Myelodysplastic syndromes (MDS) are  group of clonal diseases of the hematopoietic system characterized by ineffective hematopoiesis,  dysmyelopoiesis, a high frequency karyotype abnormalities and the risk of transformation into acute leukemias. Cytopenic and dysplastic changes are not pathognomonic for MDS, and there are many diseases that can imitate  MDS. According to various sources, clonal karyotypic abnormalities are present only in 20-60% of MDS. The diagnosis of MDS is not difficult if blasts  or  sideroblasts are present in the bone marrow, or there are chromosomal aberrations as evidence of clonal hematopoiesis. The diagnostic problem arises in cases of MDS without sideroblasts, with normal karyotype and/or bone marrow hypoplasia. Since 2012, the ELNet Working Group has proposed and subsequently supplemented guidelines for Flow Cytometry as a complementary diagnostic tool. The aim of the study was to compare the results of the FCM Wells score MDS with the results of the İPSS-R score MDS Methodology: The study included 30 patients initially diagnosed with MDS . The classification was carried out according to the WHO Classification of MDS 2016: MDS SLD-6 (20%), MDS-MLD-5 (16.7%), MDS RS-MLD-2 (6.7%), MDS-EB1-9 (30%), MDS EB2-8(27%). According to the IPPS-R, patients were scored based on blasts, cytogenetic examination, hemoglobin/platelet/absolute neutrophil count and scored as very-low, low, intermediate, high, very-high. Results: Using the Wells evaluation criteria, which takes into account  cytometric analysis of the cells of the main myelopoiesis lines, changes were found in the compartment of granulocytes in 93%, monocytes in 40% and erythrocytes in 73% of cases. High scores on the Wells scale (> 4) were obtained in  89% of (8/9) MDS-EB1, 100%(8/8) MDS-EB2, 80% (4/5) MDS MLD patients, 17% (1/6)  MDS –SLD, 50%(1/2) MDS RS-MLD. According to IPPS-R, MDS patients received a score <1.5  very low risk  group include  50%(3/6)  MDS –SLD, 20%(1/5) MDS-MLD,  score > 1.5-3 - Low risk group  include MDS –SLD 50%(3/ 6), MDS-MLD-80% (4/5), MDS RS-MLD  50% (1/2), MDS-EB1-78%(7/ 9), score > 3- 4.5-intermediate risk qroup got MDS-EB1 22%(2/ 9), MDS EB2- 25% (2/8), MDS RS-MLD- 50%(1/2), Score > 4.5 respectively high risk group got patients MDS –SLD- 17%(1/6), MDS EB2-  50%(4/8), Score > 6 very high risk group got MDS EB2- 25%(2/8). The Pearson's correlation coefficient (PCC) showed high correlation between İPSS-R and FCM Wells  score was 0.83, p<0.002. Conclusion: In our study, the FCM score had a positive correlation with the IPSS-R prediction. Expanded analysis of the main compartments of the bone marrow (early precursors of myelopoiesis, the population of granulocytes and monocytes, erythrocytes) using the Wells scale as an additional tool improves the diagnosis and distinguish low-grade MDS from non-clonal cytopenias.Reyhan AliyevaAgarza AghayevAdam NajafliReyhan TagizadeAzer KerimovElsevierarticleDiseases of the blood and blood-forming organsRC633-647.5ENHematology, Transfusion and Cell Therapy, Vol 43, Iss , Pp S26- (2021)
institution DOAJ
collection DOAJ
language EN
topic Diseases of the blood and blood-forming organs
RC633-647.5
spellingShingle Diseases of the blood and blood-forming organs
RC633-647.5
Reyhan Aliyeva
Agarza Aghayev
Adam Najafli
Reyhan Tagizade
Azer Kerimov
DIAGNOSTIC APPLICATION AND CLINICAL SIGNIFICANCE OF FCM WELLS SCORING SYSTEM IN MYELODYSPLASTIC SYNDROMES
description Objective: Myelodysplastic syndromes (MDS) are  group of clonal diseases of the hematopoietic system characterized by ineffective hematopoiesis,  dysmyelopoiesis, a high frequency karyotype abnormalities and the risk of transformation into acute leukemias. Cytopenic and dysplastic changes are not pathognomonic for MDS, and there are many diseases that can imitate  MDS. According to various sources, clonal karyotypic abnormalities are present only in 20-60% of MDS. The diagnosis of MDS is not difficult if blasts  or  sideroblasts are present in the bone marrow, or there are chromosomal aberrations as evidence of clonal hematopoiesis. The diagnostic problem arises in cases of MDS without sideroblasts, with normal karyotype and/or bone marrow hypoplasia. Since 2012, the ELNet Working Group has proposed and subsequently supplemented guidelines for Flow Cytometry as a complementary diagnostic tool. The aim of the study was to compare the results of the FCM Wells score MDS with the results of the İPSS-R score MDS Methodology: The study included 30 patients initially diagnosed with MDS . The classification was carried out according to the WHO Classification of MDS 2016: MDS SLD-6 (20%), MDS-MLD-5 (16.7%), MDS RS-MLD-2 (6.7%), MDS-EB1-9 (30%), MDS EB2-8(27%). According to the IPPS-R, patients were scored based on blasts, cytogenetic examination, hemoglobin/platelet/absolute neutrophil count and scored as very-low, low, intermediate, high, very-high. Results: Using the Wells evaluation criteria, which takes into account  cytometric analysis of the cells of the main myelopoiesis lines, changes were found in the compartment of granulocytes in 93%, monocytes in 40% and erythrocytes in 73% of cases. High scores on the Wells scale (> 4) were obtained in  89% of (8/9) MDS-EB1, 100%(8/8) MDS-EB2, 80% (4/5) MDS MLD patients, 17% (1/6)  MDS –SLD, 50%(1/2) MDS RS-MLD. According to IPPS-R, MDS patients received a score <1.5  very low risk  group include  50%(3/6)  MDS –SLD, 20%(1/5) MDS-MLD,  score > 1.5-3 - Low risk group  include MDS –SLD 50%(3/ 6), MDS-MLD-80% (4/5), MDS RS-MLD  50% (1/2), MDS-EB1-78%(7/ 9), score > 3- 4.5-intermediate risk qroup got MDS-EB1 22%(2/ 9), MDS EB2- 25% (2/8), MDS RS-MLD- 50%(1/2), Score > 4.5 respectively high risk group got patients MDS –SLD- 17%(1/6), MDS EB2-  50%(4/8), Score > 6 very high risk group got MDS EB2- 25%(2/8). The Pearson's correlation coefficient (PCC) showed high correlation between İPSS-R and FCM Wells  score was 0.83, p<0.002. Conclusion: In our study, the FCM score had a positive correlation with the IPSS-R prediction. Expanded analysis of the main compartments of the bone marrow (early precursors of myelopoiesis, the population of granulocytes and monocytes, erythrocytes) using the Wells scale as an additional tool improves the diagnosis and distinguish low-grade MDS from non-clonal cytopenias.
format article
author Reyhan Aliyeva
Agarza Aghayev
Adam Najafli
Reyhan Tagizade
Azer Kerimov
author_facet Reyhan Aliyeva
Agarza Aghayev
Adam Najafli
Reyhan Tagizade
Azer Kerimov
author_sort Reyhan Aliyeva
title DIAGNOSTIC APPLICATION AND CLINICAL SIGNIFICANCE OF FCM WELLS SCORING SYSTEM IN MYELODYSPLASTIC SYNDROMES
title_short DIAGNOSTIC APPLICATION AND CLINICAL SIGNIFICANCE OF FCM WELLS SCORING SYSTEM IN MYELODYSPLASTIC SYNDROMES
title_full DIAGNOSTIC APPLICATION AND CLINICAL SIGNIFICANCE OF FCM WELLS SCORING SYSTEM IN MYELODYSPLASTIC SYNDROMES
title_fullStr DIAGNOSTIC APPLICATION AND CLINICAL SIGNIFICANCE OF FCM WELLS SCORING SYSTEM IN MYELODYSPLASTIC SYNDROMES
title_full_unstemmed DIAGNOSTIC APPLICATION AND CLINICAL SIGNIFICANCE OF FCM WELLS SCORING SYSTEM IN MYELODYSPLASTIC SYNDROMES
title_sort diagnostic application and clinical significance of fcm wells scoring system in myelodysplastic syndromes
publisher Elsevier
publishDate 2021
url https://doaj.org/article/cc6e7a3d9e1a48228ab9feac447ebd8a
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AT adamnajafli diagnosticapplicationandclinicalsignificanceoffcmwellsscoringsysteminmyelodysplasticsyndromes
AT reyhantagizade diagnosticapplicationandclinicalsignificanceoffcmwellsscoringsysteminmyelodysplasticsyndromes
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