I Lorand-Metze1, A L Longhini1, G Oliveira-Duarte1, R P Correia2, M C Santos-Silva3, M Yamamoto4, A F Sandes5, A F Oliveira6, E X Souto7, M R V Ikoma8, F G Pereira-Cunha9, M Beltrame10, K Metze11. 1. Hematology - Hemotherapy Center, University of Campinas, Campinas, São Paulo, Brazil. 2. Laboratory of Hematology, Hospital Albert Einstein, São Paulo, Brazil. 3. Laboratory of Experimental Oncology, Federal University of Santa Catarina, Florianópolis, Brazil. 4. Department of Hematology, Federal University of São Paulo, São Paulo, Brazil. 5. Laboratory of Hematology, Laboratórios Fleury, São Paulo, Brazil. 6. Laboratory of Hematology, Childrens' Cancer Hospital, Barretos Cancer Center, Barretos, Brazil. 7. Laboratory of Hematology, DASA, São Paulo, Brazil. 8. Laboratory of Cytometry, Hospital Amaral Carvalho, Jaú, São Paulo, Brazil. 9. Laboratório Sollutio, Campinas, São Paulo, Brazil. 10. Department of Hematology, Federal University of Paraná, Curitiba, Brazil. 11. Department of Pathology, University of Campinas, Campinas, Brazil.
Abstract
BACKGROUND: Normal B lymphoid maturation occurs in bone marrow (BM) throughout life, but immature B-cell progenitors (BCPs) are more numerous in children than in adults. To assess the normal values according to age became important as BCPs are decreased in myelodysplastic syndromes and have been considered an important diagnostic and prognostic feature in these clonal disorders. METHODS: in a multicenter retrospective study from the Brazilian Group of Flow Cytometry we analyzed the variation of BCPs in normal BM according to age and technical peculiarities of each laboratory. We analysed of 45 BM donors and 89 cases examined for elucidation of transitory reactive cytopenias presenting a normal BM immunophenotyping. BCPs were enumerated as CD19+ /CD34+ /CD45dim /CD10+ cells (panel 1) or CD19+ /CD34+ /CD45dim cells (panel 2) among the total nucleated non-erythroid cells and as percentage of CD34+ cells. RESULTS: we included 134 cases. Panel 1 was applied in 88 cases and panel 2 was used in 46. Age range: 10 months to 89 years. In a multiple regression, % BCPs/total nucleated cells was an exponential function of age. Age explained alone 49.4% of the variance, while 'panel used' explained 1.8% and 'laboratory' explained 0.7%. Age explained only 24.9% of the variance of BCPs/CD34+ cells. CONCLUSIONS: in normal individuals, BM B-cell precursors varied mainly according to age, but were also dependent on technical peculiarities of operators and equipments. Analysis by phenotype and as percentage of total nucleated cells was more accurate and less susceptible to variation than evaluating % BCPs/total CD34+ cells.
BACKGROUND: Normal B lymphoid maturation occurs in bone marrow (BM) throughout life, but immature B-cell progenitors (BCPs) are more numerous in children than in adults. To assess the normal values according to age became important as BCPs are decreased in myelodysplastic syndromes and have been considered an important diagnostic and prognostic feature in these clonal disorders. METHODS: in a multicenter retrospective study from the Brazilian Group of Flow Cytometry we analyzed the variation of BCPs in normal BM according to age and technical peculiarities of each laboratory. We analysed of 45 BM donors and 89 cases examined for elucidation of transitory reactive cytopenias presenting a normal BM immunophenotyping. BCPs were enumerated as CD19+ /CD34+ /CD45dim /CD10+ cells (panel 1) or CD19+ /CD34+ /CD45dim cells (panel 2) among the total nucleated non-erythroid cells and as percentage of CD34+ cells. RESULTS: we included 134 cases. Panel 1 was applied in 88 cases and panel 2 was used in 46. Age range: 10 months to 89 years. In a multiple regression, % BCPs/total nucleated cells was an exponential function of age. Age explained alone 49.4% of the variance, while 'panel used' explained 1.8% and 'laboratory' explained 0.7%. Age explained only 24.9% of the variance of BCPs/CD34+ cells. CONCLUSIONS: in normal individuals, BM B-cell precursors varied mainly according to age, but were also dependent on technical peculiarities of operators and equipments. Analysis by phenotype and as percentage of total nucleated cells was more accurate and less susceptible to variation than evaluating % BCPs/total CD34+ cells.