Flow cytometric analysis of neutrophil myeloperoxidase expression in peripheral blood for ruling out myelodysplastic syndromes: a diagnostic accuracy study

• Published in: Haematologica (Roma) Vol. 104; no. 12; pp. 2382 - 2390
• Main Authors: Raskovalova, Tatiana, Berger, Marc G, Jacob, Marie-Christine, Park, Sophie, Campos, Lydia, Aanei, Carmen Mariana, Kasprzak, Julie, Pereira, Bruno, Labarère, José, Cesbron, Jean-Yves, Veyrat-Masson, Richard
• Format: Journal Article
• Language: English
• Published: Italy Ferrata Storti Foundation 01-12-2019
• Subjects: Hematology; Human health and pathology; Life Sciences; Microbiology and Parasitology; Myelodysplastic Syndromes; Immunophenotyping; Diagnostic accuracy study
• ISSN: 0390-6078; 1592-8721
• DOI: 10.3324/haematol.2018.202275

Suspicion of myelodysplastic syndromes (MDS) is one of the commonest reasons for bone marrow aspirate in elderly patients presenting with persistent peripheral blood (PB) cytopenia of unclear etiology. A PB assay that accurately rules out MDS would have major benefits. The diagnostic accuracy of the intra-individual robust coefficient of variation (RCV) for neutrophil myeloperoxidase (MPO) expression measured by flow cytometric analysis in PB was evaluated in a retrospective derivation study (44 MDS cases and 44 controls) and a prospective validation study (68 consecutive patients with suspected MDS). Compared with controls, MDS cases had higher median RCV values for neutrophil MPO expression (40.2%
30.9%;
<0.001). The area under the receiver operating characteristic curve estimates were 0.94 [95% confidence interval (CI): 0.86-0.97] and 0.87 (95%CI: 0.76-0.94) in the derivation and validation studies, respectively. A RCV lower than 30% ruled out MDS with 100% sensitivity (95%CI: 78-100%) and 100% negative predictive value (95%CI: 83-100%) in the prospective validation study. Neutrophil MPO expression measured by flow cytometric analysis in PB might obviate the need for invasive bone marrow aspirate and biopsy for up to 29% of patients with suspected MDS.