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P023 Lymphoid micromegakarycytes is a unfavourable prognostic factor in patients with primary myelodysplastic syndromes
2. Diagnosis and Prognostic Markers P022 Serum CD44 levels predict survival in patients with low-risk myelodysplastic syndromes R. Stauder1 ° , U. Germing2 , W. Sperr3 , P. Valent3 , H. Zwierzina4 , H. Ulmer5 , J. Loeffler-Ragg4 . 1 Department of Internal Medicine V, Medical University, Innsbruck, Innsbruck, Austria; 2 Heinrich-Heine-University, Germany; 3 Medical University of Vienna, Austria; 4 Medical University, Innsbruck, Austria; 5 Innsbruck Medical University, Austria *E-mail: [email protected] Aberrant expression of the adhesion molecule CD44 correlates with poor prognosis in various neoplasms. To evaluate the prognostic impact of CD44 in myelodysplastic syndromes (MDS) serum levels of soluble CD44 (sCD44) were measured in 130 MDS patients using an enzymelinked immunosorbent assay (ELISA). sCD44 levels were significantly elevated in MDS patients compared to healthy donors (p < 0.05), and were found to correlate with distinct FAB subtypes. The highest levels of sCD44 were found in patients with CMML and in patients with MDS transformed into acute myeloid leukemia (AML). In univariate analysis elevated levels of sCD44 s were significantly correlated with shorter overall survival in MDS-patients (9 versus 37 months; p < 000). In multivariate analysis sCD44 s displayed prognostic significance for survival independent from the International Prognosis Scoring System (IPSS). To test for refined prognostication, each IPSS risk group was split into two separate categories based on sCD44 s levels. Using this approach, MDS patients with a shorter survival were identified both in the IPSS low-risk (p = 0.014) and in the IPSS Int-1 group (p = 0.031). The CD44 s-adjusted IPSS defines a cohort of MDS patients with unfavorable prognosis within the low and intermediate-1 IPSS groups, which might be helpful in risk stratification and in therapeutic algorithms.
P023 Lymphoid micromegakarycytes is a unfavourable prognostic factor in patients with primary myelodysplastic syndromes Z. Xiao ° , W. Cui, L. Li, Y. Zhang, T. Qin. The State Key Laboratory of Experimental Hematology, Department of Clinical Hematology, Institute of Hematology and Blood Diseases Hospital, CAMS, Tianjin, China *E-mail: [email protected] Purpose: Several studies have demonstrated that the most valid prognostic scoring system used in MDS is the IPSS. Recently, a new prognostic scoring system, WPSS, was proposed based on the WHO classification. The prognostic significance of WPSS in Chinese patients with MDS was evaluated and a modified WPSS was provided.
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Methods: In order to assess the role of the main prognostic factors in MDS, 164 adult patients were retrospectively analyzed. Results: The median follow-up time was 19(1–138) months and the median survival was 36 months. 2-year survival rate was 60% and 5-year survival rate was 42%. In patients with very low-risk, low-risk, intermediate-risk, high-risk and very high-risk stratified by WPSS, 2-year survival was 100%, 96%, 81%, 38% and 14%, respectively; 5-year survival was 100%, 83%, 54%, 20% and 0, respectively (P < 0.001). Among the parameters, elevated MCV, MCH, N-ALP score and PAS negative were good prognostic factors while decreased Hb, BPC and blast more than 5%, dysplasia more than 1 lineage and lymphoid micromegakaryocyte (MEGly) presented in bone marrow, elevated LDH in serum were unfavourable prognostic factors by uni-variable analysis, and MCV, MEGly and Blast more than 5% had independent prognostic significance by multi-variable analysis (P = 0.011, 0.013 and 0.016, respectively). WPSS was modified by removing chromosomal karyotype and transfusion dependence and adding in MCV and MEGly, and the patients were stratified into low-risk, intermediaterisk and high-risk groups according to the scores. Patients with low-risk, intermediate-risk and high-risk stratified by modified WPSS, 2-year survival was 94%, 68% and 49%, respectively; 5-year survival was 86%, 53% and 14%, respectively(P < 0.001). Conclusions: WPSS based on WHO classification was adapted to prognostic determination in Chinese patients with MDS. Lymphoid micromegakaryocyte had independent prognostic significance in MDS patients.
P024 Computerized nuclear texture analysis for the characterization of atypic immature cells in MDS I. Lorand-Metze ° , J. Vido, R. Adam, K. Metze. State University of Campinas, Brazil *E-mail: [email protected] Purpose: Bone marrow (BM) cytology is essential for the diagnosis of MDS. However, in cases with many atypical cells it may be difficult to quantify precisely myeloblasts and promyelocytes. Our aim was to investigate whether computerized image analysis of routine cytology would be able to characterize these cell types. Methods: In MGG stained BM smears of 14 newly diagnosed MDS (8 RCMD, 4 RAEB, 2 RA) patients and 15 cases of normal BM, blasts, promyelocytes and atypic precursors were digitalized and interactively segmented. The classification of the cells was done by consensus of two observers. Nuclear morphometry and texture features derived from the co-occurrence matrix (Haralick features), fractal dimensions and Fast-Fourier-transformed (FFT) images were calculated.
P023 Lymphoid micromegakarycytes is a unfavourable prognostic factor in patients with primary myelodysplastic syndromes Z. Xiao ° , W. Cui, L. Li, Y. Zhang, T. Qin. The State Key Laboratory of Experimental Hematology, Department of Clinical Hematology, Institute of Hematology and Blood Diseases Hospital, CAMS, Tianjin, China *E-mail: [email protected] Purpose: Several studies have demonstrated that the most valid prognostic scoring system used in MDS is the IPSS. Recently, a new prognostic scoring system, WPSS, was proposed based on the WHO classification. The prognostic significance of WPSS in Chinese patients with MDS was evaluated and a modified WPSS was provided.
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Methods: In order to assess the role of the main prognostic factors in MDS, 164 adult patients were retrospectively analyzed. Results: The median follow-up time was 19(1–138) months and the median survival was 36 months. 2-year survival rate was 60% and 5-year survival rate was 42%. In patients with very low-risk, low-risk, intermediate-risk, high-risk and very high-risk stratified by WPSS, 2-year survival was 100%, 96%, 81%, 38% and 14%, respectively; 5-year survival was 100%, 83%, 54%, 20% and 0, respectively (P < 0.001). Among the parameters, elevated MCV, MCH, N-ALP score and PAS negative were good prognostic factors while decreased Hb, BPC and blast more than 5%, dysplasia more than 1 lineage and lymphoid micromegakaryocyte (MEGly) presented in bone marrow, elevated LDH in serum were unfavourable prognostic factors by uni-variable analysis, and MCV, MEGly and Blast more than 5% had independent prognostic significance by multi-variable analysis (P = 0.011, 0.013 and 0.016, respectively). WPSS was modified by removing chromosomal karyotype and transfusion dependence and adding in MCV and MEGly, and the patients were stratified into low-risk, intermediaterisk and high-risk groups according to the scores. Patients with low-risk, intermediate-risk and high-risk stratified by modified WPSS, 2-year survival was 94%, 68% and 49%, respectively; 5-year survival was 86%, 53% and 14%, respectively(P < 0.001). Conclusions: WPSS based on WHO classification was adapted to prognostic determination in Chinese patients with MDS. Lymphoid micromegakaryocyte had independent prognostic significance in MDS patients.
P024 Computerized nuclear texture analysis for the characterization of atypic immature cells in MDS I. Lorand-Metze ° , J. Vido, R. Adam, K. Metze. State University of Campinas, Brazil *E-mail: [email protected] Purpose: Bone marrow (BM) cytology is essential for the diagnosis of MDS. However, in cases with many atypical cells it may be difficult to quantify precisely myeloblasts and promyelocytes. Our aim was to investigate whether computerized image analysis of routine cytology would be able to characterize these cell types. Methods: In MGG stained BM smears of 14 newly diagnosed MDS (8 RCMD, 4 RAEB, 2 RA) patients and 15 cases of normal BM, blasts, promyelocytes and atypic precursors were digitalized and interactively segmented. The classification of the cells was done by consensus of two observers. Nuclear morphometry and texture features derived from the co-occurrence matrix (Haralick features), fractal dimensions and Fast-Fourier-transformed (FFT) images were calculated.