Myelodysplastic syndrome occurring after autologous bone marrow transplantation for lymphoma. Morphologic features.
Myelodysplastic syndrome occurring after autologous bone marrow transplantation for lymphoma. Morphologic features.
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淋巴瘤自体骨髓移植后发生骨髓增生异常综合征。
DOI：
10.1093/ajcp/108.4.369
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发表时间：
1997
影响因子：
3.5
通讯作者：
Brynes,RK
中科院分区：
文献类型：
--
作者：
Wilson,CS;Traweek,ST;Slovak,ML;Niland,JC;Forman,SJ;Brynes,RK
在接受自体骨髓移植 (auto-BMT) 治疗淋巴瘤的患者中，高达 18% 的患者出现骨髓增生异常综合征 (MDS) 特征的克隆核型异常。形态学变化通常很微妙，可能不符合法美英合作组织的MDS标准。我们回顾性评估了9名患者移植前后外周血和骨髓标本的发育不良变化，并将其与核型和生存率相关联。所有患者在移植前的细胞遗传学研究结果均正常，但在自体BMT后出现克隆核型异常。 4 名患者（侵袭性 MDS）存活时间较短，并死于急性髓性白血病或 MDS 相关并发症，4 名（惰性 MDS）生存期延长，1 名患者死于复发性淋巴瘤。侵袭性 MDS 组在自体 BMT 前的骨髓三系发育不良明显多于惰性 MDS 组或细胞遗传学正常的自体 BMT 对照组，这表明干细胞损伤发生在移植前，并且未被检测到。移植前细胞遗传学分析。移植后出现相对较多的红细胞生成障碍和巨核细胞生成障碍；这些变化与新发 MDS 中观察到的变化类似。惰性MDS组的移植后发育不良与移植过程相关的异型性类似。
Clonal karyotypic abnormalities characteristic of myelodysplastic syndrome (MDS) occur in up to 18% of patients who undergo autologous bone marrow transplantation (auto-BMT) for the treatment of lymphoma. Morphologic changes are often subtle and may not meet the French-American-British Cooperative Group criteria for MDS. We retrospectively assessed dysplastic changes in peripheral blood and bone marrow specimens obtained before and after transplantation from nine patients and correlated them with karyotype and survival.All patients had normal cytogenetic study results before transplantation and had clonal karyotypic abnormalities develop after auto-BMT. Four patients (with aggressive MDS) survived a short time and died of acute myelogenous leukemia or MDS-related complications, four (with indolent MDS) had a prolonged survival period, and one patient died of recurrent lymphoma.The group with aggressive MDS had significantly more bone marrow trilineage dysplasia before auto-BMT than did the group with indolent MDS or cytogenetically normal auto-BMT controls, suggesting that stem cell damage occurred before transplantation and was not detected by pretransplantation cytogenetic analysis. Comparatively greater dyserythropoiesis and dysmegakaryopoiesis were present after transplantation; these changes were similar to those seen in de novo MDS. Posttransplantation dysplasia in the group with indolent MDS was analogous to the atypia related to the transplantation process.