Transplantation and cellular therapy · 2026
A stem cell-based flow cytometry assay to predict post-transplantation relapse in patients with myelodysplastic syndromes with excess blasts: a prospective study.
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Wu Wei-Bing, Luo Ya-Wen, Li Si-Qi, Xu Lan-Ping, Wang Yu, Zhang Xiao-Hui, Sun Yu-Qian, Lv Meng, Tang Fei-Fei, Mo Xiao-Dong, Zhao Xiao-Su, Liu Kai-Yan, Huang Xiao-Jun, Chen He-Bing, Zhao Xiang-Yu, Chang Ying-Jun
Аннотация
BACKGROUND: We aim to investigate whether the myelodysplastic syndrome stem cell (MDS-SC)-based assay could be used to predict relapse and survival after treatment in patients with MDS with excess blasts (MDS-EB).
METHODS: A total of 143 cases receiving allografting were prospectively enrolled. A single-cell proteogenomic technique was used to evaluate the characteristics of CD34+ MDS subsets. These cells were detected using multiparameter flow cytometry (MFC) at diagnosis and post-treatment.
RESULTS: The phenotypically defined (PD) CD34+CD38-cocktail+ (CD56/CD22/CD11b/CD7/Tim-3/CLL-1) MDS-SCs exhibited greater stemness and quiescence than PD CD34+CD38-MDS-SCs with other immunophenotypes. A high level of pre-transplantation PD CD34+CD38-cocktail+MDS-SCs (≥0.1064%) independently predicted 3-year cumulative incidence of relapse (CIR, P<0.001). No association of pre-transplantation traditional MFC-based MDS cells with relapse was observed. Patients with positive post-transplantation PD CD34+CD38-cocktail+MDS-SCs (≥0.0081%) experienced a higher 3-year CIR (40.4% vs. 6.5%, P<0.001) and lower disease-free survival (DFS, 57.4% vs. 85.1%, P<0.001) than those negative cases. Multivariate analysis revealed that positive post-transplantation PD CD34+CD38-cocktail+MDS-SCs independently predicted CIR (P<0.001) and DFS (P<0.001). Patients with post-transplantation traditional MFC-MRD positivity also had a higher CIR (60.0% vs. 12.8%, P<0.001) and lower DFS (40.0% vs. 80.2%, P<0.001) than those negative cases. The MDS-SC-based assay has higher sensitivity and C-index for MRD detection than the traditional MFC method.
CONCLUSION: Our data suggest the potential superiority of the PD MDS-SC-based assay over the traditional MFC method for outcome prediction in MDS-EB patients.
METHODS: A total of 143 cases receiving allografting were prospectively enrolled. A single-cell proteogenomic technique was used to evaluate the characteristics of CD34+ MDS subsets. These cells were detected using multiparameter flow cytometry (MFC) at diagnosis and post-treatment.
RESULTS: The phenotypically defined (PD) CD34+CD38-cocktail+ (CD56/CD22/CD11b/CD7/Tim-3/CLL-1) MDS-SCs exhibited greater stemness and quiescence than PD CD34+CD38-MDS-SCs with other immunophenotypes. A high level of pre-transplantation PD CD34+CD38-cocktail+MDS-SCs (≥0.1064%) independently predicted 3-year cumulative incidence of relapse (CIR, P<0.001). No association of pre-transplantation traditional MFC-based MDS cells with relapse was observed. Patients with positive post-transplantation PD CD34+CD38-cocktail+MDS-SCs (≥0.0081%) experienced a higher 3-year CIR (40.4% vs. 6.5%, P<0.001) and lower disease-free survival (DFS, 57.4% vs. 85.1%, P<0.001) than those negative cases. Multivariate analysis revealed that positive post-transplantation PD CD34+CD38-cocktail+MDS-SCs independently predicted CIR (P<0.001) and DFS (P<0.001). Patients with post-transplantation traditional MFC-MRD positivity also had a higher CIR (60.0% vs. 12.8%, P<0.001) and lower DFS (40.0% vs. 80.2%, P<0.001) than those negative cases. The MDS-SC-based assay has higher sensitivity and C-index for MRD detection than the traditional MFC method.
CONCLUSION: Our data suggest the potential superiority of the PD MDS-SC-based assay over the traditional MFC method for outcome prediction in MDS-EB patients.