Background and Aims: Flow cytometry (FCM) is a fast valuable tool for detecting dysplasia in the diagnosis of MDS, with Ogata score being a simple and widely used. While phenotypic abnormalities detected by FCM often correlate with more aggressive genetic profiles in MDS, studies investigating the relationship between the Ogata score specifically and cytogenetic abnormalities remain limited.

Methods: Retrospective study with patients with confirmed MDS who underwent simultaneous bone marrow karyotyping and FCM at a specialized laboratory between 2019 and 2024. Ogata score was categorized as ≥2 versus <2 and ≥3 versus <3. Cytogenetic abnormalities were classified by karyotype status (normal vs. abnormal), number of abnormalities (0, 1, 2, ≥3), and IPSS-R cytogenetic risk groups (very good/good, intermediate, poor/very poor). Statistical analysis was performed using Spearman correlation, Fisher's exact test, and Chi-square tests.

Results: 93 patients, median age 74 years (30-93), 45.2% male, 62 patients newly diagnosed, median CD34+ cell count 2.2% (range: 0-17.3). Ogata scores ≥2 and ≥3 were observed in 74.2% and 52.7% of patients, respectively. Cytogenetic analysis revealed abnormal karyotypes in 50.5% of patients, with 18.3% classified as complex. Although no statistically significant association was found between the Ogata score and IPSS-R stratification or number of cytogenetic abnormalities, patients with an Ogata score ≥3 had a significantly higher frequency of abnormal karyotypes (30/49) compared to those with a score <3 (17/44) (p=0.0085).

Conclusion: Ogata score ≥3 was significantly associated with the presence of cytogenetic abnormalities in these MDS population as reported in the literature with FCM scores other than Ogata's.

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2025
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