Phenotypic landscape of granulocytes and monocytes by multiparametric flow cytometry: A prospective study of a 1‐tube panel strategy for diagnosis and prognosis of patients with MDS

Background Multiparametric flow cytometry (MFC) was recently reported to be a helpful additional tool in the diagnosis of myelodysplastic syndromes (MDS). However, numerous aberrancies have been reported that makes their evaluation difficult as part of a routine diagnosis. Methods Here, we validated a 1‐tube panel for the evaluation of granulocytic and monocytic maturation by MFC and correlated our findings with diagnosis and prognosis of MDS. A total of 251 samples with MDS suspicion were prospectively analyzed and compared to an internal reference database leading to the calculation of the Diff score. Results The associated specificity and sensitivity values of this scoring system were 92.1% and 60.4% in a first learning cohort and 96.7% and 65.2% in a second independent validation cohort. The combination of the Diff score with the concomitantly calculated Ogata score increased the sensitivity to 74.2% and 78.3% in the learning and validation cohorts, respectively. Finally, a normal Diff score in MDS patients was associated with a significant prolonged progression‐free survival. Conclusions Taken together, the present data indicate that our strategy is a sensitive and specific MFC tool for the diagnosis of MDS‐related cytopenia(s) which could be also useful for predicting evolution of these diseases.