Transient/reversible ring sideroblasts in bone marrow of patients post cytotoxic therapies for primary malignancies
Transient/reversible ring sideroblasts in bone marrow of patients post cytotoxic therapies for primary malignancies
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DOI：
10.1016/j.leukres.2011.04.021
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发表时间：
2011-12-01
影响因子：
2.7
通讯作者：
Wang, Sa A.
中科院分区：
文献类型：
--
作者：
Ok, Chi Young;Medeiros, L. Jeffrey;Wang, Sa A.
在没有成髓细胞增多或细胞遗传学异常的情况下，诊断与治疗相关的骨髓增生异常综合征(t-MDS)是具有挑战性的。在这种情况下，环状成铁细胞(RS)的存在通常被用来支持t-MDS的诊断。在这项研究中，我们回顾了该院10年来最初被归类为治疗相关髓系肿瘤的843例患者。19例(2.3%)患者核型正常，15%(17-70%)为RS，构成本研究组。在回顾了临床病历和随访的骨髓标本后，我们确认了13例MDS的诊断，但在6例患者的血细胞计数恢复正常，RS和相关的红细胞生成障碍在随访的骨髓活检中消失。中位随访21个月，这6例患者无一例死于BM原因。与t-MDS病例相比，6例短暂性/可逆性RS患者的RS和BM原始细胞数目相当，但罕见的非红系异型增生。我们的结论是，在治疗后的环境中，>；=15%RS的存在并不一定表明是克隆性干细胞肿瘤。4名短暂性/可逆性RS患者接受了α-干扰素治疗，这可能有助于在这种情况下RS的形成。(C)2011爱思唯尔有限公司。保留所有权利。
The diagnosis of therapy-related myelodysplastic syndrome (t-MDS) in the absence of increased myeloblasts or cytogenetic abnormalities is challenging. The presence of ring sideroblasts (RS) in this setting is often used to support the diagnosis of t-MDS. In this study, we reviewed 843 patients initially classified as therapy-related myeloid neoplasm in our hospital over 10 years. Nineteen (2.3%) patients had a normal karyotype, 15% RS (17-70%), forming this study group. After reviewing clinical charts and follow-up BM specimens, we confirmed the diagnosis of MDS in 13 patients, but in 6 patients the blood counts returned to normal and RS and associated dyserythropoiesis disappeared in the follow-up BM biopsy. With a median follow-up of 21 months, none of these 6 patients died of BM causes. Compared with t-MDS cases, the 6 patients with transient/ reversible RS showed comparable numbers of RS and BM blasts, but infrequent dysplasia involving non-erythroid lineages. We conclude that the presence of >= 15% RS in the post-therapy setting is not necessarily indicative of a clonal stem cell neoplasm. Four patients with transient/reversible RS received alpha-interferon therapy which may contribute to RS formation in this setting. (C) 2011 Elsevier Ltd. All rights reserved.