A New Diagnostic Approach for Myelodysplastic Neoplasms Using a Combination of Scores Based on Flow Cytometry and Automated Hematology Sysmex XN Analyzers

Abstract

Introduction

The first-step in diagnosis of myelodysplastic neoplasms (MDS) is essentially based on bone marrow cytomorphology. However, cytomorphology of MDS is often a difficult exercise, subject to inter-operator variability. Our study aims to evaluate whether the combination of two dysplasia scores, the extended Ogata score and the MDS-CBC score, could improve the screening of MDS patients among patients with chronic cytopenia.

Methods

Extended Ogata score and MDS-CBC score have been measured on a retrospective cohort of 63 patients with a clinical suspicion of MDS based on the presence of cytopenia. Among these patients, 33 patients were diagnosed as MDS (MDS group) and 30 patients were diagnosed with another cause of cytopenia (non-MDS cytopenic control group).

Results

Our results show excellent performance of the combined scores in predicting MDS when the two scores are concordant: positive predictive value (PPV) = 96% and negative predictive value (NPV) = 92%. In comparison, in the same cohort, extended Ogata score alone showed a PPV = 90% and NPV = 79%, MDS-CBC score alone showed a PPV = 85% and NPV = 86%.

Conclusion

For the first time, our results show that the combination of these two dysplasia scores constitutes a useful and rapid tool for the assessment of dysplasia associated with MDS. In the MDS diagnostic process, the use of combined scores could constitute a valuable tool to enable early strong prediction of MDS in cytopenic patients and to target patients who initially require additional genetic assays.