Wells et al developed a score for the myelodysplastic syndrome (MDS) based on flow cytometric findings. One component involves the presence of various abnormalities involving myeloid cells. The authors are from the Hematologics, Inc, Fred Hutchinson Cancer Research Center, and the University of Washington, Seattle.
Patient selection: myelodysplasia with <= 30% myeloblasts
Parameters:
(1) granularity
(2) CD45
(3) CD11b expression
(4) HLA-DR expression
(5) CD33 expression
(6) CD56 expression
(7) CD34 expression
(8) expression of other lymphoid markers (CD19, CD5, CD7)
(9) shift to the left
|
Parameters |
Finding |
Points |
|
granularity |
normal |
0 |
|
|
abnormal |
1 |
|
CD45 expression |
normal |
0 |
|
|
abnormal decrease |
|
|
HLA-DR and CD11b |
HLA-DR absent AND CD11b present |
0 |
|
|
HLA DR present OR CD11b absent |
|
|
CD13 and CD16 expression |
both coexpressed normally |
0 |
|
|
convex or abnormal relationship |
1 |
|
CD56 |
absent |
0 |
|
|
present on a subpoplation of myeloid cells |
1 |
|
CD33 expression |
normal |
0 |
|
|
absent |
1 |
|
shift to the left |
absent or synchronous |
0 |
|
|
asynchronous |
1 |
subscore for initial abnormalities =
= SUM(points for all 7 measures)
|
Initial Abnormalities |
CD34 Expression on Myeloid Cells |
Other Lymphoid Markers on Myeloid Cells |
Points for Myeloid Abnormalities |
|
0 |
0 |
0 |
0 |
|
1 |
0 |
0 |
1 |
|
2 or 3 |
0 |
0 |
2 |
|
4 or 5 |
0 |
0 |
3 |
|
0 |
1 |
0 |
2 |
|
0 |
0 |
1 |
2 |
|
1 or more |
1 |
0 |
3 |
|
1 or more |
0 |
1 |
3 |
|
1 or more |
1 |
1 |
3 |
|
Additional Measures |
Findings |
Additional Points |
|
myeloblasts |
< 5% and normal |
0 |
|
|
< 5% and clearly abnormal |
1 |
|
|
5 to 10% |
2 |
|
|
11 to 20% |
3 |
|
|
21 to 30% |
4 |
|
lymphoid to myeloid ratio |
< 1 |
0 |
|
|
>=1 |
1 |
subscore for myeloid abnormalities =
= (points for myeloid abnormalities) + (additional points)
Interpretation:
• minimum score: 0
• maximum score: 8
Specialty: Hematology Oncology, Clinical Laboratory
ICD-10: ,
