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Iliac bone marrow findings and prognosis in MDS patients
1.5
Second International Conference on Myelodysplastic Syndromes
SECTION H - POSTER PRESENTATIONS Classification syndromes Histologic
of the Myelodysplastic Criteria for their (MDS): Recognition.
Bertha Frisch Institute of
Aviv,
and Reiner
Bartl.
Haematology, Ichilov and Bon,e Marrow Diagnosis,
Hospital Tel Munich Univ.
In retrospective and prospective studies from 1975 to 1991, bone marrow biopsies, aspirates and clinical features of 495 patients with MDS were investigated. Sections of undecalcified plastic embedded biopsies and smears with of bone marrow aspirates were stained Giemsa. Bone marrows with MDS were characterised by three main categories of morphological alterations: 1)cellular abnormalities, P)architectural disorganisation of the bone marrow, 3)stromal changes; the combined use of aspirates and trephine biopsies enabled a more reliable and accurate diagnosis of MDS than either one alone. The bone marrow findings fell into one of with the frequencies and 7 subtypes, median survivals in brackets: 1)MDS sideroblastic(19X.62 months), 2)MDS megaloblastoid(l3X. 56 months), 3)MDS proliferative(22X,31months), 4)MDS blastic(l5%,9months). 5)MDS hypoplastic (15%.26months). 6)MDS fibrotic (6%.29 months), and7)MDS inflammatory(lOX.42 months).In follow with secondary MDS were up studies patients excluded and the prognosis and subsequent evolution for each of the morphological sub-
DISTURBANCES OF HAEMOPOIETIC ORGANISATION AND MATURATION IN MYELODYSPLASTIC SYNDROMES DEMONSTRATED BY DIFFERENTIAL STAINING WITH IMMUNOHISTOCHEMICAL MARKERS B S Wilkins, D B Jones University Dept of Pathology, Southampton General Hospital, SOUTHAMPTON SO9 4XY Antibodies showing restricted reactivity with individual haemopoietic cell lineages and/or maturation stages were used to stain bone marrow trephine biopsies representing primary myelodysplastic syndromes. Anti-alpha- and beta-sialoglycoprotein antibodies distinguished early and late erythroid precursors. Antibodies to CD68, CD15, muramidase, neutrophil elastase and calgranulin allowed differential staining of early and late granulocytes and monocytes. CD61 detected megakaryocytes. With these antibodies we were able to demon-strate marked spatial disturbances of haemopoietic cell organisation and to characterise many of the abnormal clusters of immature cells found in the myelodysplastic biopsies.
typeswere evaluated.The conclusionis drawn that aspirates and trephine biopsies are
complementary procedures and both are required for diagnosis, classification and decisions on current treatment modalities for patients with
MDS. ILIAC BONE hmROW FINDINGS AND PROGNOSIS IN MDS PATIENTS L.L.Yavorkoveky tine, RIGA)
(Latvian
Academy of
Medi-
A series of 58 patients with MDS were studied: RA.41 patients; RAEB,13 patients; IV.EB-t,4 patients. In this sequence of BIDS variants the following histologic findings tended to be more conuson: increased cellularity, presence of predominant cell type, abnormal localization of immature precursincluding those within sinusoors (ALIP), ids, marked perivascular plasurocytosis and fibrosis. Opposite tendency seemed obvious in respect of lymphoid nodules. Increased cellularity, predominant cell type (except erythroid), large number of ALIP and decreased number or striking features of ?egakaryocytes ? were of poor prognostic significance regardless of the LIDIDs type. The group of FAB-CAW patients (n-76) was shown to be not homogeneous. Bone marrow findingsvaried and were helpful ill
distinguishingat least three different entitieswith diverse prognosis:1) Iw and
HAEB with monocytosis (MDS subvariants), 2) myelomonocytic dysplasia (new MDS variant) and 3) true CMML (disorder other than MDS).
HAEMATOLOGICAL,
RAOIOLOGICAL
MYELOOISPLASTIC Resegotti
SYNOROHES
L, Depaoli
Giovinazzo
6.
University
of Torino,
Several
Avanzi
of
MDS
terms
of
marrow
histology
type
and
of
associated
and
nies.
Stimulation
cases
an
noic
acid
in
as
documented of
in
which
cells
cases
MD, and
the
uhereas
feu
IL3.
in
growth. an
it by
displayed
17
case.
clusters and
cell
inhibited
Epo
Semi-
and
no
induced
in
on
furacti-
analysis. were
normal
documented
all
growth
proliferative
alterations
of
colo-
transreti-
action
apparently WePe
always
differentiation; the
the
clusters
phase,
autoradiographic
an
noted
single
uas
of
in
of
frequent
a number
inhibitory
cytochemical
abnormalities
uas
Independently
liquid
28
between
thrombocytopenia.
GM-CSF
affecting
observed
neutropenia
In
of
concordance
most
or
and
a series
correlation
level.
anaemia
Cytogenetic evaluable
Epo
with
cases
Foggetti
radiological in
been
inverse
was
displayed
quarter
has
erythroid
thermore
IN
Hospital
complete
very
however, 5
A
produced
increase
0,
assessed
cultures
without,
vity
An
either
precursors,
STUDIES
Molinette
histological,
serum
feature,
vitro
.
been
anaemia
with
in
P, Davini R
diagnosis.
NMR.
MOS,
presentation
GM
Fo2
cellularity
anaemia
solid
Lista
have
at
BIOLOGICAL
Italy
features
cases
between
L, GC,
haematological,
biological
AND
(MM)
In
a
observed
morphology. in
6
of
the
Second International Conference on Myelodysplastic Syndromes
SECTION H - POSTER PRESENTATIONS Classification syndromes Histologic
of the Myelodysplastic Criteria for their (MDS): Recognition.
Bertha Frisch Institute of
Aviv,
and Reiner
Bartl.
Haematology, Ichilov and Bon,e Marrow Diagnosis,
Hospital Tel Munich Univ.
In retrospective and prospective studies from 1975 to 1991, bone marrow biopsies, aspirates and clinical features of 495 patients with MDS were investigated. Sections of undecalcified plastic embedded biopsies and smears with of bone marrow aspirates were stained Giemsa. Bone marrows with MDS were characterised by three main categories of morphological alterations: 1)cellular abnormalities, P)architectural disorganisation of the bone marrow, 3)stromal changes; the combined use of aspirates and trephine biopsies enabled a more reliable and accurate diagnosis of MDS than either one alone. The bone marrow findings fell into one of with the frequencies and 7 subtypes, median survivals in brackets: 1)MDS sideroblastic(19X.62 months), 2)MDS megaloblastoid(l3X. 56 months), 3)MDS proliferative(22X,31months), 4)MDS blastic(l5%,9months). 5)MDS hypoplastic (15%.26months). 6)MDS fibrotic (6%.29 months), and7)MDS inflammatory(lOX.42 months).In follow with secondary MDS were up studies patients excluded and the prognosis and subsequent evolution for each of the morphological sub-
DISTURBANCES OF HAEMOPOIETIC ORGANISATION AND MATURATION IN MYELODYSPLASTIC SYNDROMES DEMONSTRATED BY DIFFERENTIAL STAINING WITH IMMUNOHISTOCHEMICAL MARKERS B S Wilkins, D B Jones University Dept of Pathology, Southampton General Hospital, SOUTHAMPTON SO9 4XY Antibodies showing restricted reactivity with individual haemopoietic cell lineages and/or maturation stages were used to stain bone marrow trephine biopsies representing primary myelodysplastic syndromes. Anti-alpha- and beta-sialoglycoprotein antibodies distinguished early and late erythroid precursors. Antibodies to CD68, CD15, muramidase, neutrophil elastase and calgranulin allowed differential staining of early and late granulocytes and monocytes. CD61 detected megakaryocytes. With these antibodies we were able to demon-strate marked spatial disturbances of haemopoietic cell organisation and to characterise many of the abnormal clusters of immature cells found in the myelodysplastic biopsies.
typeswere evaluated.The conclusionis drawn that aspirates and trephine biopsies are
complementary procedures and both are required for diagnosis, classification and decisions on current treatment modalities for patients with
MDS. ILIAC BONE hmROW FINDINGS AND PROGNOSIS IN MDS PATIENTS L.L.Yavorkoveky tine, RIGA)
(Latvian
Academy of
Medi-
A series of 58 patients with MDS were studied: RA.41 patients; RAEB,13 patients; IV.EB-t,4 patients. In this sequence of BIDS variants the following histologic findings tended to be more conuson: increased cellularity, presence of predominant cell type, abnormal localization of immature precursincluding those within sinusoors (ALIP), ids, marked perivascular plasurocytosis and fibrosis. Opposite tendency seemed obvious in respect of lymphoid nodules. Increased cellularity, predominant cell type (except erythroid), large number of ALIP and decreased number or striking features of ?egakaryocytes ? were of poor prognostic significance regardless of the LIDIDs type. The group of FAB-CAW patients (n-76) was shown to be not homogeneous. Bone marrow findingsvaried and were helpful ill
distinguishingat least three different entitieswith diverse prognosis:1) Iw and
HAEB with monocytosis (MDS subvariants), 2) myelomonocytic dysplasia (new MDS variant) and 3) true CMML (disorder other than MDS).
HAEMATOLOGICAL,
RAOIOLOGICAL
MYELOOISPLASTIC Resegotti
SYNOROHES
L, Depaoli
Giovinazzo
6.
University
of Torino,
Several
Avanzi
of
MDS
terms
of
marrow
histology
type
and
of
associated
and
nies.
Stimulation
cases
an
noic
acid
in
as
documented of
in
which
cells
cases
MD, and
the
uhereas
feu
IL3.
in
growth. an
it by
displayed
17
case.
clusters and
cell
inhibited
Epo
Semi-
and
no
induced
in
on
furacti-
analysis. were
normal
documented
all
growth
proliferative
alterations
of
colo-
transreti-
action
apparently WePe
always
differentiation; the
the
clusters
phase,
autoradiographic
an
noted
single
uas
of
in
of
frequent
a number
inhibitory
cytochemical
abnormalities
uas
Independently
liquid
28
between
thrombocytopenia.
GM-CSF
affecting
observed
neutropenia
In
of
concordance
most
or
and
a series
correlation
level.
anaemia
Cytogenetic evaluable
Epo
with
cases
Foggetti
radiological in
been
inverse
was
displayed
quarter
has
erythroid
thermore
IN
Hospital
complete
very
however, 5
A
produced
increase
0,
assessed
cultures
without,
vity
An
either
precursors,
STUDIES
Molinette
histological,
serum
feature,
vitro
.
been
anaemia
with
in
P, Davini R
diagnosis.
NMR.
MOS,
presentation
GM
Fo2
cellularity
anaemia
solid
Lista
have
at
BIOLOGICAL
Italy
features
cases
between
L, GC,
haematological,
biological
AND
(MM)
In
a
observed
morphology. in
6
of
the