A flow cytometric approach to compare stem cell apoptosis in aplastic anemia and hypoplastic myelodysplastic syndrome

Background and Objectives
Aplastic anemia (AA) is a disease caused by bone marrow (BM) failure. There are many similarities between AA and hypoplastic myelodysplastic syndrome (MDS); hence, differentiating them could be problematic. The current study aimed to use the new technique of flow cytometry as a possible diagnostic tool for AA and hypoplastic MDS.


Patients and Methods
The BM mononuclear cell (BMMC) and blood samples from 44 participants (17 patients with AA, 13 with hypoplastic MDS, and 14 healthy controls) were collected. The flow cytometric analysis of the cluster of differentiation 34 (CD34) levels and cell apoptosis was performed for all sample types.


Results
Patients with hypoplastic MDS showed a high percentage of CD34+ cells with low apoptosis, while those with AA showed a low percentage of CD34+ cells with high apoptosis.


Conclusions
Despite the similarity in the clinical presentation of hypoplastic MDS and AA, they are biologically different disorders. Increased CD34+ cell numbers with high viability may provide a useful and accurate tool for the differential diagnosis of hypoplastic MDS from AA.