Contribuição da citometria de fluxo para o diagnóstico e prognóstico das síndromes mielodisplásicas

Abstract

The diagnosis of MDS is based on the presence of peripheral cytopenias together with cell atypias in bone marrow precursors and cytogenetic abnormalities. However, in several cases, the cell atypias are discrete, and/or the karyotype is normal, precluding a clear-cut diagnosis. Multiparametric flow cytometry is a fast, reproducible and relatively inexpensive technique, which is able to disclose changes in the expression of lineage and maturation related antigens. Several of such abnormalities have been described in MDS. Three or four-color protocols have been used to analyze erythroblasts, granulocytes, monocytes and blasts, permitting, in most of the cases, the differential diagnosis between MDS and non-clonal disorders presenting pancytopenia. Flow cytometry is also useful in the follow-up of the patients, since it has been described that progression of the MDS clone is accompanied by an increase in the number of phenotypic abnormalities and of CD34+ cells, as well as the decrease in pro-apoptotic markers in bone marrrow cells.