Utility of peripheral blood flow cytometry in differentiating low grade versus high grade myelodysplastic syndromes (MDS) and in the evaluation of cytopenias

The diagnostic utility of flow cytometry in the evaluation of cytopenias and in the differential diagnosis of low -grade versus high-grade myelodysplastic syndrome (MDS) is not widely appreciated. In this report, we measured granulocyte CD10/control fluorescence ratio in 29 patients with MDS & chronic myelomonocytic leukemia (CMML) using peripheral blood (PB) flow cytometry (FC). We found a lower ratio in high-grade MDS and CMML (mean ratio of 2.2 ± 0.7) vs. low-grade MDS (3.65 ± 0.9) and 16 cytopenic controls without MDS (3.67 ± 0.65; p<0.001). The sensitivity and specificity of CD10 ratio <3 for the group that included the high risk MDS and CMML patients were 87.5% and 100%, respectively. Our data suggests that FC of PB may be helpful in the work-up of patients with cytopenias and in the differential diagnosis of low-grade vs. high-grade MDS.