Proposal of criteria for dyserythropoiesis in the diagnosis of myelodysplastic syndromes.
Proposal of criteria for dyserythropoiesis in the diagnosis of myelodysplastic syndromes.
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骨髓增生异常综合征诊断中红细胞生成障碍标准的提议。
DOI：
10.1007/s12185-015-1916-8
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发表时间：
2016
期刊：
影响因子：
2.1
通讯作者：
Tomonaga M.
中科院分区：
文献类型：
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作者：
Kawai N;Matsuda A;Jinnai I;Ichimura T;Kayano H;Okamura D;Ishikawa M;Maeda T;Hata T;Miyazaki Y;Asou N;Bessho M;Tomonaga M.
在每个谱系中，骨髓中表现出异常增生的百分比需要达到显著性≥10%。然而，对这一阈值的详细分析尚未报道。在这里，我们分析了109例骨髓增生异常综合征（MDS）患者的红细胞生成（dysE），其中21例为免疫性血小板减少症(ITP)/12例为溶血性贫血（HA）患者作为对照。在本研究中，将轻度巨幼细胞红母细胞特别命名为“异常染色质聚集红细胞（RCACC）”。在29%的ITP患者和58%的HA患者中观察到红细胞中RCACC≥10%。红细胞中RCACC <10、10 - 19和≥20%的MDS患者分别为1、3和105例。我们根据WHO分类（原始WHO dysE）分析了dysE标准。大多数MDS患者（98%）的原始WHO dysE≥20%。原始WHO dysE≥10%的ITP患者占48%，没有原始WHO dysE≥20%的ITP患者。67%的HA患者初始WHO dysE≥10%，3例（25%）患者初始WHO dysE≥20%。将世卫组织最初的死亡率阈值从10%提高到20%或30%可能会提供更合适的标准。如果rccc不包括在dysE标准中，我们认为“10%”是一个合适的阈值来确定红细胞生成。
The percentage manifesting dysplasia in bone marrow needed to qualify as significant is ≥10 % in each lineage. However, detailed analyses of this threshold have not been reported. Here, we analyzed dyserythropoiesis (dysE) in 109 myelodysplastic syndromes (MDS) patients with 21 immune thrombocytopenia (ITP)/12 hemolytic anemia (HA) patients as a control. In present study, mild megaloblastic erythroblasts were specifically named ‘red cell with abnormal chromatin clumping (RCACC)’. RCACC ≥10 % in erythroblasts was observed in 29 % of ITP patients and 58 % of HA patients. The numbers of MDS patients with RCACC in erythroblasts <10, 10–19 and ≥20 % were 1, 3, and 105, respectively. We analyzed dysE criteria according to the WHO classification (original WHO dysE). Most of our MDS patients (98 %) had original WHO dysE ≥20 %. The ITP patients with original WHO dysE ≥10 % was 48 %, and there were no ITP patients had original WHO dysE ≥20 %. Sixty-seven percent of HA patients had original WHO dysE ≥10 %, and three patients (25 %) had original WHO dysE ≥20 %. Raising the threshold of the original WHO dysE from 10 to 20 or 30 % may provide more suitable criteria. If RCACC is not included in dysE criteria, we think that ‘10 %’ is a suitable threshold for the determination of dyserythropoiesis.