A simple flow cytometric assay for routine paroxysmal nocturnal hemoglobinuria testing based on immature reticulocytes and granulocytes

Cytometry B Clin Cytom. 2012 Jul;82(4):259-63. doi: 10.1002/cyto.b.21030. Epub 2012 May 30.

Abstract

Background: The aim of this study was to test an easy-to-perform flow cytometric (FCM) assay for the routine investigation for diagnosis of paroxysmal nocturnal hemoglobinuria (PNH), through the simultaneous detection of PNH clones on immature reticulocytes (i-RET) and granulocytes.

Methods: During the last 5 years, eight patients were diagnosed with PNH in our laboratory, among 90 patients prospectively studied for PNH. The determination of glycosylphosphatidylinositol (GPI) deficient cells on the erythroid lineage was made with a two-color FCM assay of CD71 and CD59, evaluating the PNH clone on i-RET. Three color combinations based on CD66b/CD16/CD45 and CD59/CD24/CD45 were used for the determination of GPI-deficient granulocytes.

Results: In all the patients with PNH, the PNH clones determined with CD71(+)CD59(-) red blood cells (RBC) were nearly identical to the respective clones determined with CD16(dim/-)/CD66b(-) and CD59(-)/CD24(-) granulocytes, in contrast to the clones determined with CD59-deficient erythrocytes only, which were significantly lower.

Conclusions: Our results indicate that the simultaneous assessment of the PNH clone on CD71(+)/CD59(-)i-RET and CD16(dim/-)/CD66b(-) granulocytes, could offer a reliable method of two series PNH screening, at low cost and with ease of application.

MeSH terms

  • Adult
  • Antigens, CD / blood
  • Antigens, CD / metabolism
  • Biomarkers / blood
  • Biomarkers / metabolism
  • Female
  • Flow Cytometry*
  • Hemoglobinuria, Paroxysmal / blood
  • Hemoglobinuria, Paroxysmal / diagnosis*
  • Hemoglobinuria, Paroxysmal / pathology
  • Humans
  • Male
  • Neutrophils / metabolism*
  • Prospective Studies
  • Reticulocytes / metabolism*

Substances

  • Antigens, CD
  • Biomarkers