Enumeration of CD34+ blasts by immunohistochemistry in bone marrow biopsies from MDS patients may have significant impact on final WHO classification
(2020) In Journal of Hematopathology 13(2). p.79-88- Abstract
The percentage of blasts cells in the bone marrow (BM) of MDS patients is one of the key parameters for MDS classification and for the differential diagnosis with acute myeloid leukemia (AML). Currently, the gold standard to determine the blast percentage is conventional cytomorphology. To assess the possible impact of blast cell enumeration in BM biopsies from MDS patients on the final WHO classification using CD34 immunohistochemistry (IHC) a total of 156 BM samples from MDS and MDS-AML patients were studied and compared to blast counts by cytomorphology (CM). Eighty-nine BM aspirates were also studied by flow cytometry (FCM). Percentages of CD34+ blasts by IHC were determined blindly by two hematopathologists. Automated CD34-cell... (More)
The percentage of blasts cells in the bone marrow (BM) of MDS patients is one of the key parameters for MDS classification and for the differential diagnosis with acute myeloid leukemia (AML). Currently, the gold standard to determine the blast percentage is conventional cytomorphology. To assess the possible impact of blast cell enumeration in BM biopsies from MDS patients on the final WHO classification using CD34 immunohistochemistry (IHC) a total of 156 BM samples from MDS and MDS-AML patients were studied and compared to blast counts by cytomorphology (CM). Eighty-nine BM aspirates were also studied by flow cytometry (FCM). Percentages of CD34+ blasts by IHC were determined blindly by two hematopathologists. Automated CD34-cell count was performed in 25 cases. Good overall agreement was found for CM and FCM with respect to critical blast thresholds (5%, 10%, 20%) (p < 0.05). However, in 17% of patients, CD34+ blast counts by IHC were higher as compared to CM with possible impact on MDS subclassification. In 7 of 21 AML patients, diagnosis was established on BM histology, while the blast percentage by CM was below the AML threshold. The assessment of CD34+ cells by IHC showed high interobserver agreement (Spearman R 0.95, p < 0.01), while automated CD34 counts were not optimal due to interference with other cellular and stromal elements. BM histology including CD34 IHC improves the diagnostic accuracy in MDS and AML. The quantification of blast cells should be based on the integration of all three methods for reliable disease classification and risk assessment.
(Less)
- author
- Saft, Leonie ; Timar, Botond and Porwit, Anna LU
- organization
- publishing date
- 2020-06-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Blast percentage, Bone marrow biopsy, CD34 immunohistochemistry, Cytomorphology, Flow cytometry
- in
- Journal of Hematopathology
- volume
- 13
- issue
- 2
- pages
- 10 pages
- publisher
- Springer
- external identifiers
-
- scopus:85084123983
- ISSN
- 1868-9256
- DOI
- 10.1007/s12308-020-00394-9
- language
- English
- LU publication?
- yes
- id
- 0a082294-3c42-4843-9946-452dcb79ab65
- date added to LUP
- 2021-01-14 09:17:18
- date last changed
- 2022-04-26 23:34:54
@article{0a082294-3c42-4843-9946-452dcb79ab65,
abstract = {{<p>The percentage of blasts cells in the bone marrow (BM) of MDS patients is one of the key parameters for MDS classification and for the differential diagnosis with acute myeloid leukemia (AML). Currently, the gold standard to determine the blast percentage is conventional cytomorphology. To assess the possible impact of blast cell enumeration in BM biopsies from MDS patients on the final WHO classification using CD34 immunohistochemistry (IHC) a total of 156 BM samples from MDS and MDS-AML patients were studied and compared to blast counts by cytomorphology (CM). Eighty-nine BM aspirates were also studied by flow cytometry (FCM). Percentages of CD34+ blasts by IHC were determined blindly by two hematopathologists. Automated CD34-cell count was performed in 25 cases. Good overall agreement was found for CM and FCM with respect to critical blast thresholds (5%, 10%, 20%) (p < 0.05). However, in 17% of patients, CD34+ blast counts by IHC were higher as compared to CM with possible impact on MDS subclassification. In 7 of 21 AML patients, diagnosis was established on BM histology, while the blast percentage by CM was below the AML threshold. The assessment of CD34+ cells by IHC showed high interobserver agreement (Spearman R 0.95, p < 0.01), while automated CD34 counts were not optimal due to interference with other cellular and stromal elements. BM histology including CD34 IHC improves the diagnostic accuracy in MDS and AML. The quantification of blast cells should be based on the integration of all three methods for reliable disease classification and risk assessment.</p>}},
author = {{Saft, Leonie and Timar, Botond and Porwit, Anna}},
issn = {{1868-9256}},
keywords = {{Blast percentage; Bone marrow biopsy; CD34 immunohistochemistry; Cytomorphology; Flow cytometry}},
language = {{eng}},
month = {{06}},
number = {{2}},
pages = {{79--88}},
publisher = {{Springer}},
series = {{Journal of Hematopathology}},
title = {{Enumeration of CD34+ blasts by immunohistochemistry in bone marrow biopsies from MDS patients may have significant impact on final WHO classification}},
url = {{http://dx.doi.org/10.1007/s12308-020-00394-9}},
doi = {{10.1007/s12308-020-00394-9}},
volume = {{13}},
year = {{2020}},
}