Improvement of criteria for refractory cytopenia with multilineage dysplasia according to the WHO classification based on prognostic significance of morphological features in patients with refractory anemia according to the FAB classification
Improvement of criteria for refractory cytopenia with multilineage dysplasia according to the WHO classification based on prognostic significance of morphological features in patients with refractory anemia according to the FAB classification
复制标题
DOI：
10.1038/sj.leu.2404571
复制
发表时间：
2007-04-01
期刊：
影响因子：
11.4
通讯作者：
Tomonaga, M.
中科院分区：
文献类型：
--
作者：
Matsuda, A.;Germing, U.;Tomonaga, M.
在WHO（世界卫生组织）分类的难治性细胞减少伴多系发育不良（RCMD）标准中，各系发育不良的频率阈值定义为10%。为了根据法国-美国-英国（FAB）分类预测难治性贫血（RA）患者的总生存期（OS）和无白血病生存期（LFS），我们基于100名日本和87名德国FAB-RA患者的形态学特征研究了预后因素，不包括5q综合征。在所有患者的单因素分析中，伪Pelger- huet异常>= 10% （Pelger+）、微巨核细胞>= 10% （mMgk+）、颗粒生成异常(dys G) > 10%和巨核生成异常(dys Mgk) >= 40%是OS和LFS的不利预后因素（OS; P < 0.001， LFS; P < 0.001）。形态学特征对日本和德国患者预后的影响相似。然而，Mgk >= 10%的天数与OS和LFS无关。在多因素分析中，mMgk+和Mgk >= 40%是所有患者OS的不良预后因素，g> = 10%和Mgk >= 40%是所有患者LFS的不良预后因素。在目前分析的基础上，我们提出以下修改的形态学标准的RCMD。修正后的RCMD应定义为ab - ra，排除5q综合征，即g> = 10%, Mgk >= 40%或mMgk+。
In the criteria of refractory cytopenia with multilineage dysplasia (RCMD) according to the WHO (World Health Organization) classification, the frequency threshold concerning dysplasia of each lineage was defined as 10%. To predict overall survival (OS) and leukemia-free survival (LFS) for patients with refractory anemia (RA) according to the French-American-British (FAB) classification, we investigated prognostic factors based on the morphological features of 100 Japanese and 87 German FAB-RA patients, excluding 5q-syndrome. In the univariate analysis of all patients, pseudo-Pelger-Huet anomalies >= 10% (Pelger+), micromegakaryocytes >= 10% (mMgk+), dysgranulopoiesis (dys G) > 10% and dysmegakaryopoiesis (dys Mgk) >= 40% were unfavorable prognostic factors for OS and LFS (OS; P < 0.001, LFS; P < 0.001). The prognostic effects of the morphological features were similar in both Japanese and German patients. However, dys Mgk >= 10% was not correlated with OS and LFS. In the multivariate analysis, mMgk+ and dys Mgk >= 40% were adverse prognostic factors for OS for all patients, and dys G >= 10% and dys Mgk >= 40% were adverse prognostic factors for LFS for all patients. On the basis of the present analysis, we propose the following modified morphological criteria for RCMD. Modified RCMD should be defined as FAB-RA, excluding 5q-syndrome with dys G >= 10%, dys Mgk >= 40% or mMgk+.