Lab Technology Advances Detection of MDS

The BC-6800Plusauto hematology analyzer could help distinguish which patients with cytopenia have myelodysplastic syndromes (MDS) and which have other nonneoplastic disorders, investigation results in Diagnostics indicate.¹

Diagnosis is challenging using the diagnostic tools that are currently most common—the presence of peripheral blood cytopenias, peripheral blood and bone marrow dysplasia/blasts, and clonal cytogenetic abnormalities—because MDS diagnostic features are polymorphic and nonspecific, the authors wrote. Yet early diagnosis is crucial for treatment to be as beneficial as possible.

When anemia is the only abnormality—especially in an older patient, who might be expected to have a certain degree of anemia—making a correct MDS diagnosis can be a complicated process.² Several parameters featured in the BC-6800Plus show promise in this differential diagnosis arena, particularly Neu X and Neu Y, which are related to cytoplasmic complexity of neutrophils and to neutrophils’ nucleic acid content, respectively. These most potently predicted for MDS, according to the authors’ multivariable logistic regression model.

Study authors note that common MDS diagnostic tools are challenging because the feature of the hematological cancer are polymorphic and nonspecific. | Image Credit: Coetzee peopleimages-stock.adobe.com

The team investigated the utility of this analyzer’s complete blood count (CBC) and research-use-only (RUO) parameter results, specifically, for discriminating MDS-related cytopenia. First, they used 100 samples from healthy individuals to establish RUO values in normal subjects. Then, they undertook a retrospective study of 66 patients diagnosed with MDS, 90 patients who had cytopenia due to other diseases or conditions (including cancer therapy, aplastic anemia, and other hematological malignancies), and 50 patients with macrocytic anemia.

In the MDS group, compared with patients with cytopenia and healthy patients, Neu X and Neu Y were lower, as were Neu Z (related to cell size), platelets, red cells, and white cells. Conversely, in the MDS group, the mean cell volume, percentage of macrocytic red cells (MAC), red cell distribution width (RDW), and immature platelets fraction (IPF) were increased compared with measurements in the patients with cytopenia and healthy patients.

With an area under the curve (AUC) measurement of 0.88, the multivariable model demonstrated that Neu X and Neu Y could be used to recognize MDS, wrote the researchers. Additionally, Neu Z—along with Neu X and Neu Y—had an AUC measurement of greater than 0.80 for detecting MDS, while the AUC was greater than 0.76 for MAC, RDW, and IPF in detecting MDS.

The project continued with a prospective study that included a validation group of 224 patients with cytopenia: 55 with MDS and 169 with nonneoplastic cytopenia causes. In this group, 89.0% of the patients with MDS were well classified with the BC-6800Plus and the authors’ methods, they declared.

Brand Competition

Mindray Diagnostics makes the BC-6800Plusanalyzer, noted the investigators, but it’s not the only hematology analyzer on the market; other makers include Sysmex, Abbott, and Beckman Coulter. Granularity index data can be obtained from these instruments as well, the authors stated. Indeed, of the RUO parameters, the most attention has been paid to those related to granulocyte dysplasia, a typical MDS feature.

“Despite different technologies, Neu X provided by analyzers from different brands was correlated with the morphological change of neutrophil-decreased granules,” they reported.

Nonetheless, variabilities among analyzers makes are “a true drawback, which makes the universal use of RUO parameters difficult,” they said. “Other manufacturers apply different technologies and also report RUO parameters characteristic of the specific counter.”

Neu X, Neu Y, and Neu Z, for instance, are proprietary to Mindray analyzers.

References

1. Urrechaga E, Fernández M, Aguirre U. Complete blood counts and research parameters in the detection of myelodysplastic syndromes. Diagnostics. 2024;14(13):1322. doi:10.3390/diagnostics1413132

2. Santini V. Anemia as the main manifestation of myelodysplastic syndromes. Semin Hematol. 2015;52(4):348-356. doi:10.1053/j.seminhematol.2015.06.002