Prognostic factors in myelodysplastic syndromes: a cytologic, histologic and cytogenetic study

Third International Pmgnnstic a cytologic,

factors in histologic

Myelody0pbdic ad cytapnetic

Symposium on Myelodysplastic Syndromes synamnm: study

SCUZA,. J.M., FERNANDEZ, T.S., ABDELHAY, E.S.F.W. Instituto Estadual de Hematologia and Instituto de Biofisica da UFRJ, Rio de Janeiro, Brazil Hematological, histological and cytogenetical analyses v&e performed in 50 patients with Primary Myelodysplastic Syndrunes (MDS). Twenty one were characterized as RA, 10 AISA, 7 RAE8, 6 RAEBt, and 6 0NL according to the FAB criteria for marrow smears. Bone marrow blasts and increased reticulin fibers were present in 22 cases (44%), independently. The tone marrow biopsy of 21 (42%) patients of different subgnxrps of FAB classification has shown atw~l.localizated imnature myeloid precursors (ALIP) (3 tjith RA, 2 AISA, 6 RAE8, 6 Chranosomal analysis was abnormal in 28 RAE8tand4CN-U. patients (56%); 19 patients (90,5%) 'dtith ALIP+ had a aknormslkaryotype. The follow-up of these patients occured during 4 to 70 months and dentonstrated that thirty one patients (62%) tire still alive at the date of analysis and 19 (383) had died. me median survival time&as 14 months. Three patients survived more than 3 years and 4 patients developed acute leukaemia. RA and AISA patients (31) shcwd longer survival than RAEB, RAEBt and m patients (19) when the survival tima was conpared between the two groups (P 0.01). A decreased survival time was observed in patients -With the presence of bone nw-rw blasts (P 0.011, fibrosis (P 0.05) and ALIP (P 0.05). Chranownal analyses showed no significant relationship to the lengh of survival.

Immaoopbtnotype Transformation

YlalmmgIvfDS): lbMil&DYBPLAsTIcs progwieBuQonaadaowbigQstems. Sou& E.X.; Silva, MRR.;

Transformation of acute leukemia (AL) occurs in 10% to 35% of MDS. Blast cells from leukemic transformation of MDS are classically assumed to be myeloid lineage but lympboblastic transformation was occasionally reported. In this study, leukemic cells from 23 patients witb MDS in acute transformation were analyzed by morpbology, cytocbemical and imunocytocbemical staining, and gene rearras~~eats of immunoglobulin (Ig) and Tcell receptor (TCR) we. All 23 leekemiar were classified as acute myeloid leukemia according to cell morpbology and cytocbemical staining criteria of FAB t%s&iition. Among them, 4 presented mixed mydoblast and small lympbow-like cells, wbile the rest of 19 classical myeloblast cells. ImmuaocytocbemicaI staining using monoclonal antibodies to mydokl- and lympboid-ass&iated antigens was performed in 19 patients. Expression of lympboid antigens OR the surface of blasts was detected in 5, including 2 of the 4 patients with small lympboblast-like cells. Analysis of Ig and TCR gene reanagcmant was done in 16 patients. Rearrangement of Ig heavy chain gene was observed in 1 and of TCR chain gene in another 1 patient; and both bad lympboid antigen expression. In summary, the majority of AL transformed from MDS bdonged to acute myeloid leukemia, wbik a fm were mixed mydoid and lymphoid lineage.

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and Genotype of MDS in Acute

Y.C. Cben, H.F. Tien, C.H. Waw M.C. Sben, D.T. Lin, K.H. Lin National Taiwan University Hospital, Taipei, Taiwan

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KAZUHIRO NAGAI, M. D. , TOMOKO KOHNO. M. D. HIDEKI TSUWMA, M.D.. HlFtOYUKl MCftI. M. D. , KAZUTAKA KURIYAMA. M D. , MASAO TOMONAGA, M. D. , and JOHN M. EtENNElT, M. D: Dspt. of Hematology, w Univ. school of Medklne. Japan UniveMy of Ro&eaW New York, USA Thedklkalend bestlckrfflsd,sincemsrsisno inw&g&ors cauatrq aamfuakn m MDS. saps&& RAEB OT RAE&t. In which could &arty deime features, we reviewed 27 pravkuety dtagnoaed HL. Two independent morphatagice#y(24/n cases obaetvers coukl gain higf~ly concordant asHLexceptfor3caseaofMDs;S6.9% concordnurce).AUagraed24HLcaass showed smoldering clinical course without oqanemegafy, amsidorable of le&unkbWUeinperiphsrslbkod. whilatin wncytopenia~rembone marrow(Sfvt). compartng with RAES or RAE&1 eaaea, hy$&xaflufarity less than 4O%, mainly type I blasta pro&ratkn rat’&@ fmm 32.0 to 96.0% with a median of 64.0% in non-erythroid ceffa(eMud&~g fymphocyfee; NEC). and c&la. In 76 lit cases treated with markedfy reduced kw doss Am-C( ramtsskn(CR rate 10116; t32.5%), in con noCRcaae. 2PR rly within short cases) by same regimen. 9 CR caeas, remission duration rangad from 4 month to 12 mo etudii indicate that HL is a distinct subtype of act&a teukemk with unique hematokgical featurea and htgf~ reaponae rate by LDAC in aontfaet wfth MDS. For the definite diagnosis, fotloMg pr&oatcftleMmtgMbe ;SMhypocdWbiityiess than4O%.,thef3Mbfaet parcentlge e#toea& 3bK in NEC, -8, and lack of oqanomeg&y Prospective farge &zafe studtes are r~&d for cfartfying bkkgkal features and new Mmpautk approaches of this clinical entity l