Fuzhou, China – Flow immunophenotyping can help diagnose primary myelofibrosis (MF) and differentiate between essential thrombocythemia (ET) and polycythemia vera (PV), according to a new study published in the journal Clinical Cytometry.
It is difficult to differentiate between the different types of myeloproliferative neoplasms (MPNs), such as ET, PV, and MF, the authors noted.
To test whether flow cytometry (FCM) can help diagnose and differentiate between different types of MPNs, a team of researchers from China retrospectively analyzed 211 patients with Philadelphia chromosome (Ph)-negative MPN and 47 controls.
The researchers assessed the patients’ immunophenotypes, clinical characteristics, and laboratory findings.
The results showed that primary MF was different than ET and PV in terms of white blood cells, hemoglobin levels, blast cells in the peripheral blood, karyotype, and the expression of Wilm’s tumor gene 1 (WT1).
It was also different than controls in terms of CD34-positive cells, granulocyte and monocyte phenotype, percentage of plasma cells, and dendritic cells.
Using machine learning, the researchers identified 5 variables that can distinguish primary MF with a sensitivity of 90% and a specificity of 90%.
These variables were CD34- and CD19-positive cells, CD34-positive and CD38-negative cells on CD34-positive cells, CD13dim-positive and CD11b-negative cells in granulocytes, CD38str-positive and CD19-positive or negative plasma, and CD123-positive HLA and DR-negative basophils.
The researchers also constructed a classification and regression tree model using the percentage of CD34-positive and CD38-negative on CD34-positive cells and platelet counts to differentiate between ET and prefibrotic MF with accuracies of 94.3% and 83.9%, respectively.
“Our study suggests that FCM immunotyping is valuable in the differential diagnosis of classical Ph-negative MPN,” Fujian Medical University lead investigator Prof. Feng Zhang said.
“In the future, we will investigate whether the addition of FCM immunophenotyping variables can optimize the existing prognostic models of Ph-negative MPN,” he continued.
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