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Prepublished online as a Blood First Edition Paper on December 27, 2002; DOI 10.1182/blood-2002-03-0947.
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Blood, 1 May 2003, Vol. 101, No. 9, pp. 3386-3390
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Prevalence and clinical characteristics of myelodysplastic
syndrome with bone marrow eosinophilia or basophilia
Takafumi Matsushima,
Hiroshi Handa,
Akihiko Yokohama,
Jun Nagasaki,
Hiromi Koiso,
Yoshitora Kin,
Yoko Tanaka,
Tohru Sakura,
Norifumi Tsukamoto,
Masamitsu Karasawa,
Katsuhiko Itoh,
Hisami Hirabayashi,
Morio Sawamura,
Shogo Shinonome,
Shun-ichi Shimano,
Shuichi Miyawaki,
Yoshihisa Nojima, and
Hirokazu Murakami
From the Third Department of Internal Medicine, Gunma
University School of Medicine, Japan; National Nishigunma
Hospital, Gunma, Japan; Fujioka General Hospital, Gunma, Japan; Fukaya
Red Cross Hospital, Saitama, Japan; Gunma Cancer Center, Japan;
Saiseikai Maebashi Hospital, Gunma, Japan; Division of Blood
Transfusion Service, Gunma University Hospital, Japan;
National Takasaki Hospital; and School of Health Sciences Faculty of
Medicine, Gunma University, Japan.
By retrospectively analyzing 288 patients with de novo
myelodysplastic syndrome (MDS), we sought to determine the prevalence and clinical characteristics of bone marrow eosinophilia and basophilia that were detected at presentation. Bone marrow eosinophilia and basophilia were defined as a differential count of each cell type exceeding 5.0% and 1.0%, respectively. Of 288 patients with MDS, 36 (12.5%) fulfilled this criterion for bone marrow eosinophilia (MDS-Eos); 34 patients (11.8%) showed basophilia (MDS-Bas), and 11 (3.8%) satisfied both criteria (MDS-EosBas). The remaining 229 patients had neither eosinophilia nor basophilia in their bone marrow
(MDS /) at presentation. Cytogenetic analysis was
carried out on unstimulated bone marrow cells obtained from 264 patients. When the cytogenetic categorization of the IPSS
(International Prognostic Scoring System) for MDS was applied,
significantly higher numbers of MDS-Eos and MDS-Bas patients had
chromosomal abnormalities carrying intermediate or poor prognosis,
compared with the MDS/ patients. Specific chromosomal
abnormalities and complex karyotypes were associated with MDS-Eos
and/or MDS-Bas. In accordance with these results, the overall survival
rate was significantly lower, and the evolution to acute myelogenous
leukemia (AML) occurred more frequently in the MDS-Eos and MDS-Bas than
in the MDS/ patients. Multivariate analysis
demonstrated that bone marrow basophilia was an independent risk factor
for evolution to AML. Our study indicates that bone marrow eosinophilia
and basophilia in patients with MDS predict a poorer prognosis.
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