MAR 29, 2022

The Role of Flow Cytometry in Diagnosis of Myelodysplastic Syndromes

WRITTEN BY: Katie Kokolus

Myelodysplastic syndromes (MDS) describe cancers resulting from abnormal cells in the bone marrow. The abnormal bone marrow cells generate defective blood cells, which die earlier than normal blood cells. Additionally, the body naturally eliminates abnormal blood cells. Thus, patients with MDS cannot maintain enough healthy blood cells.    

There are three main types of blood cells: red blood cells (RBCs), white blood cells (WBCs), and platelets.  RBCs, also known as erythrocytes, transport oxygen between the lungs and the rest of the body.  WBCs, also called leukocytes, contain immune cells which protect the body from foreign invaders.  Platelets are small cell pieces involved in blood clotting. 

Cytopenia refers to a condition where the counts of at least one type of blood cell is lower than expected. When a patient presents with low RBCs, WBCs, or platelet counts, they would have anemialeukopenia, or thrombocytopenia, respectively.  Pancytopenia occurs when all three blood cell types are low.

The diagnostic testing for patients with cytopenia suspected of MDS includes flow cytometric analysis. Despite the guidelines including this testing, the added value of the analysis remains unclear. A recent study published in Cytometry Part B Clinical Cytometry describes how flow cytometry (FCM) complements other diagnostic tests allowing doctors to make a definitive MDS diagnosis. The authors present six separate case studies in which FCM, in combination with observed clinical features and other diagnostic tools, led doctors to determine if the patient had MDS or not.

FCM is a laboratory procedure that analyzes the characteristics of cells.  For FCM testing, di ferent proteins on or in the cells are tagged using fluorescent-labeled antibodies.  Cells are then suspended in fluid and injected into the flow cytometer.  The cells can then be analyzed based on their size and the proteins they express.

The authors conclude that all six studies described in their manuscript demonstrate different ways FCM can assist in fast and efficient diagnosis early in the clinical investigation.  Importantly, FCM works as a complement to other tools in the diagnostic process. 

 

Sources: Cytometry B Clin Cytom, Curr Protocol Immunol