Application of immunophenotypic analysis in distinguishing chronic myelomonocytic leukemia from reactive monocytosis

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: The purpose of this study was to determine whether immunophenotypic profiles detected by flow cytometry are useful in differentiating chronic myelomonocytic leukemia (CMML) from reactive monocytosis, and between CMML subtypes. Methods: Eight-color flow cytometry was used to immunophenotype blasts, monocytes, and granulocytes in the bone marrow of 34 patients with CMML and 12 patients with reactive monocytosis. Results: Bone marrow myeloblast, promonocyte, and monocyte counts by flow cytometry were significantly higher in the CMML group than in the reactive monocytosis group. Myeloblast aberrancies were present in all CMML patients as compared with 2 of 12 (16.7%) reactive monocytosis patients (P < 0.001). The number of blast aberrancies ranged from one to nine (median, four) in CMML patients and 94.1% of CMML cases exhibited ≥ two aberrancies. In contrast, two reactive monocytosis cases showed only one phenotypic abnormality of blasts. Monocyte and granulocyte aberrancies were present in 26 of 34 (76.5%) and in 31 of 34 (91.2%) CMML patients, respectively. Decreased side scatter (SSC) and abnormal CD11b/CD13/CD16 maturation pattern in granulocytes were more frequent in CMML than in reactive monocytosis. No significant differences in antigen expression were detected between the CMML subtypes except that altered CD45/SSC pattern on the blasts was more commonly observed in CMML-0/1 than in CMML-2. Conclusions: CMML has phenotypic aberrancies in monocytes, granulocytes, and more frequently in myeloblasts. Aberrant expression of two or more antigens in myeloblasts by flow cytometry has a high sensitivity (94.1%) and a high specificity (100%) to differentiate CMML from reactive monocytosis.

Original languageEnglish (US)
Pages (from-to)901-909
Number of pages9
JournalCytometry Part B - Clinical Cytometry
Volume94
Issue number6
DOIs
StatePublished - Nov 1 2018

Fingerprint

Leukemia, Myelomonocytic, Chronic
Granulocyte Precursor Cells
Granulocytes
Monocytes
Flow Cytometry
Monocyte-Macrophage Precursor Cells
Bone Marrow
Antigens

Keywords

  • chronic myelomonocytic
  • cytometryimmunophenotype
  • leukemiareactive
  • monocytosisflow

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Cell Biology

Cite this

@article{fae4355a950b4ebe91a00a54ffabd939,
title = "Application of immunophenotypic analysis in distinguishing chronic myelomonocytic leukemia from reactive monocytosis",
abstract = "Objectives: The purpose of this study was to determine whether immunophenotypic profiles detected by flow cytometry are useful in differentiating chronic myelomonocytic leukemia (CMML) from reactive monocytosis, and between CMML subtypes. Methods: Eight-color flow cytometry was used to immunophenotype blasts, monocytes, and granulocytes in the bone marrow of 34 patients with CMML and 12 patients with reactive monocytosis. Results: Bone marrow myeloblast, promonocyte, and monocyte counts by flow cytometry were significantly higher in the CMML group than in the reactive monocytosis group. Myeloblast aberrancies were present in all CMML patients as compared with 2 of 12 (16.7{\%}) reactive monocytosis patients (P < 0.001). The number of blast aberrancies ranged from one to nine (median, four) in CMML patients and 94.1{\%} of CMML cases exhibited ≥ two aberrancies. In contrast, two reactive monocytosis cases showed only one phenotypic abnormality of blasts. Monocyte and granulocyte aberrancies were present in 26 of 34 (76.5{\%}) and in 31 of 34 (91.2{\%}) CMML patients, respectively. Decreased side scatter (SSC) and abnormal CD11b/CD13/CD16 maturation pattern in granulocytes were more frequent in CMML than in reactive monocytosis. No significant differences in antigen expression were detected between the CMML subtypes except that altered CD45/SSC pattern on the blasts was more commonly observed in CMML-0/1 than in CMML-2. Conclusions: CMML has phenotypic aberrancies in monocytes, granulocytes, and more frequently in myeloblasts. Aberrant expression of two or more antigens in myeloblasts by flow cytometry has a high sensitivity (94.1{\%}) and a high specificity (100{\%}) to differentiate CMML from reactive monocytosis.",
keywords = "chronic myelomonocytic, cytometryimmunophenotype, leukemiareactive, monocytosisflow",
author = "Ru Feng and Bhatt, {Vijaya R} and Kai Fu and Pirruccello, {Samuel Jay} and Ji Yuan",
year = "2018",
month = "11",
day = "1",
doi = "10.1002/cyto.b.21721",
language = "English (US)",
volume = "94",
pages = "901--909",
journal = "Cytometry Part B - Clinical Cytometry",
issn = "1552-4949",
publisher = "Wiley-Liss Inc.",
number = "6",

}

TY - JOUR

T1 - Application of immunophenotypic analysis in distinguishing chronic myelomonocytic leukemia from reactive monocytosis

AU - Feng, Ru

AU - Bhatt, Vijaya R

AU - Fu, Kai

AU - Pirruccello, Samuel Jay

AU - Yuan, Ji

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Objectives: The purpose of this study was to determine whether immunophenotypic profiles detected by flow cytometry are useful in differentiating chronic myelomonocytic leukemia (CMML) from reactive monocytosis, and between CMML subtypes. Methods: Eight-color flow cytometry was used to immunophenotype blasts, monocytes, and granulocytes in the bone marrow of 34 patients with CMML and 12 patients with reactive monocytosis. Results: Bone marrow myeloblast, promonocyte, and monocyte counts by flow cytometry were significantly higher in the CMML group than in the reactive monocytosis group. Myeloblast aberrancies were present in all CMML patients as compared with 2 of 12 (16.7%) reactive monocytosis patients (P < 0.001). The number of blast aberrancies ranged from one to nine (median, four) in CMML patients and 94.1% of CMML cases exhibited ≥ two aberrancies. In contrast, two reactive monocytosis cases showed only one phenotypic abnormality of blasts. Monocyte and granulocyte aberrancies were present in 26 of 34 (76.5%) and in 31 of 34 (91.2%) CMML patients, respectively. Decreased side scatter (SSC) and abnormal CD11b/CD13/CD16 maturation pattern in granulocytes were more frequent in CMML than in reactive monocytosis. No significant differences in antigen expression were detected between the CMML subtypes except that altered CD45/SSC pattern on the blasts was more commonly observed in CMML-0/1 than in CMML-2. Conclusions: CMML has phenotypic aberrancies in monocytes, granulocytes, and more frequently in myeloblasts. Aberrant expression of two or more antigens in myeloblasts by flow cytometry has a high sensitivity (94.1%) and a high specificity (100%) to differentiate CMML from reactive monocytosis.

AB - Objectives: The purpose of this study was to determine whether immunophenotypic profiles detected by flow cytometry are useful in differentiating chronic myelomonocytic leukemia (CMML) from reactive monocytosis, and between CMML subtypes. Methods: Eight-color flow cytometry was used to immunophenotype blasts, monocytes, and granulocytes in the bone marrow of 34 patients with CMML and 12 patients with reactive monocytosis. Results: Bone marrow myeloblast, promonocyte, and monocyte counts by flow cytometry were significantly higher in the CMML group than in the reactive monocytosis group. Myeloblast aberrancies were present in all CMML patients as compared with 2 of 12 (16.7%) reactive monocytosis patients (P < 0.001). The number of blast aberrancies ranged from one to nine (median, four) in CMML patients and 94.1% of CMML cases exhibited ≥ two aberrancies. In contrast, two reactive monocytosis cases showed only one phenotypic abnormality of blasts. Monocyte and granulocyte aberrancies were present in 26 of 34 (76.5%) and in 31 of 34 (91.2%) CMML patients, respectively. Decreased side scatter (SSC) and abnormal CD11b/CD13/CD16 maturation pattern in granulocytes were more frequent in CMML than in reactive monocytosis. No significant differences in antigen expression were detected between the CMML subtypes except that altered CD45/SSC pattern on the blasts was more commonly observed in CMML-0/1 than in CMML-2. Conclusions: CMML has phenotypic aberrancies in monocytes, granulocytes, and more frequently in myeloblasts. Aberrant expression of two or more antigens in myeloblasts by flow cytometry has a high sensitivity (94.1%) and a high specificity (100%) to differentiate CMML from reactive monocytosis.

KW - chronic myelomonocytic

KW - cytometryimmunophenotype

KW - leukemiareactive

KW - monocytosisflow

UR - http://www.scopus.com/inward/record.url?scp=85055084546&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055084546&partnerID=8YFLogxK

U2 - 10.1002/cyto.b.21721

DO - 10.1002/cyto.b.21721

M3 - Article

VL - 94

SP - 901

EP - 909

JO - Cytometry Part B - Clinical Cytometry

JF - Cytometry Part B - Clinical Cytometry

SN - 1552-4949

IS - 6

ER -