Abnormal CD13/HLA-DR Expression Pattern on Myeloblasts Predicts Development of Myeloid Neoplasia in Patients With Clonal Cytopenia of Undetermined Significance

Dragan Jevremovic, Ahmad Nanaa, Susan Geyer, Michael Timm, Haya Azouz, Cynthia Hengel, Alexander Reberg, Rong He, David Viswanatha, Mohamed Salama, Min Shi, Horatiu Olteanu, Pedro Horna, Gregory Otteson, Patricia T. Greipp, Zhuoer Xie, Hassan B. Alkhateeb, William Hogan, Mark Litzow, Mrinal M. PatnaikMithun Shah, Aref Al-Kali, Phuong L Nguyen

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: Patients with clonal cytopenia of undetermined significance (CCUS) are at increased risk of developing myeloid neoplasia (MN). We evaluated whether a simple flow cytometry immunophenotyping (FCIP) assay could differentiate the risk of development of MN in patients with CCUS. METHODS: Bone marrow aspirates were assessed by FCIP panel in a cohort of 80 patients identified as having CCUS based on next-generation sequencing or cytogenetics from March 2015 to May 2020, with available samples. Flow cytometric assay included CD13/HLA-DR expression pattern on CD34-positive myeloblasts; CD13/CD16 pattern on maturing granulocytic precursors; and aberrant expression of CD2, CD7, or CD56 on CD34-positive myeloblasts. Relevant demographic, comorbidity, and clinical and laboratory data, including the type and extent of genetic abnormalities, were extracted from the electronic health record. RESULTS: In total, 17 (21%) patients with CCUS developed MN over the follow-up period (median survival follow-up, 28 months [95% confidence interval, 19-31]). Flow cytometry immunophenotyping abnormalities, including the aberrant pattern of CD13/HLA-DR expression, as detected at the time of the diagnosis of CCUS, were significantly associated with risk of developing MN (hazard ratio, 2.97; P = .006). Additional FCIP parameters associated with the development of MN included abnormal expression of CD7 on myeloblasts and the presence vs absence of any FCIP abnormality. CONCLUSIONS: A simple FCIP approach that includes assessment of CD13/HLA-DR pattern on CD34-positive myeloblasts can be useful in identifying patients with CCUS at higher risk of developing MN.

Original languageEnglish (US)
Pages (from-to)530-536
Number of pages7
JournalAmerican journal of clinical pathology
Volume158
Issue number4
DOIs
StatePublished - Oct 6 2022

Keywords

  • CCUS
  • Flow cytometry
  • MDS
  • Myeloid neoplasia

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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