Altered immunophenotypic features of peripheral blood platelets in myelodysplastic syndromes

• Published in: Haematologica (Roma) Vol. 97; no. 6; pp. 895 - 902
• Main Authors: SANDES, Alex F, YAMAMOTO, Mihoko, MATARRAZ, Sergio, CHAUFFAILLE, Maria De Lourdes L. F, QUIJANO, Sandra, LOPEZ, Antonio, OGURO, Tsutomu, KIMURA, Eliza Y. S, ORFAO, Alberto
• Format: Journal Article
• Language: English
• Published: Pavia Ferrata Storti Foundation 01.06.2012
• Subjects: Aged; Aged, 80 and over; Antigens, CD - genetics; Antigens, CD - immunology; Biological and medical sciences; Biomarkers - analysis; Blood Platelets - immunology; Blood Platelets - metabolism; Blood Platelets - pathology; Dual Specificity Phosphatase 2 - genetics; Dual Specificity Phosphatase 2 - immunology; Female; Fibrinogen - genetics; Fibrinogen - immunology; Flow Cytometry; Gene Expression Regulation, Neoplastic - immunology; Hematologic and hematopoietic diseases; Humans; Immunophenotyping; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Megakaryocytes - immunology; Megakaryocytes - metabolism; Megakaryocytes - pathology; Middle Aged; Myelodysplastic Syndromes - immunology; Myelodysplastic Syndromes - mortality; Myelodysplastic Syndromes - pathology; Original and Brief Reports; Pilot Projects; Platelet Activation - genetics; Platelet Activation - immunology; Prognosis; Risk; Severity of Illness Index; Survival Rate; Thrombocytopenia - immunology; Thrombocytopenia - mortality; Thrombocytopenia - pathology; Flow cytometry; Dysplasia; Hematology; Immunophenotype; Megakaryocyte; Malignant hemopathy; megakaryocytic dysplasia; Blood; Myelodysplastic syndrome; platelets; Platelet; immunophenotyping; myelodysplastic syndromes; Cancer
• ISSN: 0390-6078; 1592-8721
• DOI: 10.3324/haematol.2011.057158

Multiparameter flow cytometric analysis of bone marrow and peripheral blood cells has proven to be of help in the diagnostic workup of myelodysplastic syndromes. However, the usefulness of flow cytometry for the detection of megakaryocytic and platelet dysplasia has not yet been investigated. The aim of this pilot study was to evaluate by flow cytometry the diagnostic and prognostic value of platelet dysplasia in myelodysplastic syndromes. We investigated the pattern of expression of distinct surface glycoproteins on peripheral blood platelets from a series of 44 myelodysplastic syndrome patients, 20 healthy subjects and 19 patients with platelet alterations associated to disease conditions other than myelodysplastic syndromes. Quantitative expression of CD31, CD34, CD36, CD41a, CD41b, CD42a, CD42b and CD61 glycoproteins together with the PAC-1, CD62-P, fibrinogen and CD63 platelet activation-associated markers and platelet light scatter properties were systematically evaluated. Overall, flow cytometry identified multiple immunophenotypic abnormalities on platelets of myelodysplastic syndrome patients, including altered light scatter characteristics, over-and under expression of specific platelet glycoproteins and asynchronous expression of CD34; decreased expression of CD36 (n = 5), CD42a (n = 1) and CD61 (n = 2), together with reactivity for CD34 (n = 1) were only observed among myelodysplastic syndrome cases, while other alterations were also found in other platelet disorders. Based on the overall platelet alterations detected for each patient, an immunophenotypic score was built which identified a subgroup of myelodysplastic syndrome patients with a high rate of moderate to severe alterations (score>1.5; n = 16) who more frequently showed thrombocytopenia, megakaryocytic dysplasia and high-risk disease, together with a shorter overall survival. Our results show the presence of altered phenotypes by flow cytometry on platelets from around half of the myelodysplastic syndrome patients studied. If confirmed in larger series of patients, these findings may help refine the diagnostic and prognostic assessment of this group of disorders.