Affiliation:
1. From the Departments of Hematopathology, Biostatistics, and Leukemia, The University of Texas MD Anderson Cancer Center, Houston.
Abstract
Abstract
Myelodysplastic syndrome (MDS) is a disease characterized by ineffective hematopoiesis. There are significant biologic and clinical differences between MDS and acute myeloid leukemia (AML). We studied a cohort of 802 patients, 279 (35%) with newly diagnosed MDS and 523 (65%) with newly diagnosed AML, and compared clinical and biologic characteristics of the 2 groups. Complete clinical and cytogenetic data were available on all patients, and a subgroup of patients was studied for apoptosis, angiogenesis, proliferation, and growth factors. Our results demonstrate that MDS is a discrete entity that is different from AML and is characterized primarily by increased apoptosis in early and mature hematopoietic cells. Using cell sorting and loss of heterozygosity, we demonstrate that the leukemic cells from MDS patients are capable of differentiation into mature myeloid cells and monocytes. We also demonstrate that there is a significant overlap between AML and MDS when MDS is defined on the basis of an arbitrary percentage of blasts of 20% or 30%. These data suggest that despite similarities between AML and MDS in their responses to treatment and outcomes, MDS is biologically and clinically different from AML and should not be considered an early phase of AML. The data indicate that MDS must be better defined on the basis of its biology rather than the percentage of blasts; further, the data suggest that there is a need to develop therapeutic approaches that specifically address the biologic abnormalities of MDS.
Publisher
American Society of Hematology
Subject
Cell Biology,Hematology,Immunology,Biochemistry
Reference43 articles.
1. Myelodysplasia.;Heaney;N Engl J Med.,1999
2. Myelodysplastic syndromes (preleukemia).;Koeffler;Semin Hematol.,1986
3. Myelodysplastic (preleukemia) syndromes: the bone marrow factory failure problem.;Hoagland;Mayo Clin Proc.,1995
4. Recent advances in biology and treatment of myelodysplasia.;Heyman;Curr Opin Oncol.,1991
5. Myelodysplastic syndromes: natural history and features of prognostic importance.;Mufti;Clin Haematol.,1986
Cited by
111 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献