CD36 relative mean fluorescence intensity of CD105(+) nucleated erythroid cells can be used to differentiate myelodysplastic syndrome from megaloblastic anemia

This study aims to evaluate the differences in CD105(+) nucleated erythroid cell (NEC) immunophenotypes between myelodysplastic syndrome (MDS) and megaloblastic anemia (MA) using multiparameter flow cytometry and to screen potential markers. We analyzed bone marrow sample data from 37 patients with MDS, 35 with MA, 53 with iron-deficiency anemia (anemic controls), and 35 without anemia (normal controls). Compared with normal controls, the MDS and MA groups showed a decrease in the proportion of CD117(+)CD105(+)NEC and the relative mean fluorescence intensity (RMFI) of CD71 in CD105(+)NEC, accompanied by an increase in the coefficient of variation (CV) of CD71 and CD36. Additionally, CD36 RMFI of CD105(+)NEC increased in the MA group. Compared with anemia controls, the MDS and MA groups showed a significant increase in CD36 CV of CD105(+)NEC, and the CD36 RMFI in the MA group increased while that in the MDS group decreased. The proportions of CD117(+)CD105(+)NEC, CD36 CV, and CD36 RMFI in CD105(+)NEC differed significantly between MDS and MA groups. Among them, CD36 RMFI had good diagnostic performance (area under the curve: 0.844, 95% confidence interval: 0.753–0.935). CD36 RMFI of CD105(+)NEC may be a helpful marker in differentiating MDS and MA using multiparameter flow cytometry.