Clinical significance of phenotypic features of blasts in patients with myelodysplastic syndrome
Clinical significance of phenotypic features of blasts in patients with myelodysplastic syndrome
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DOI：
10.1182/blood-2002-01-0222
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发表时间：
2002-12-01
期刊：
影响因子：
20.3
通讯作者：
Yoshida, Y
中科院分区：
文献类型：
--
作者：
Ogata, K;Nakamura, K;Yoshida, Y
与其他恶性肿瘤一样，对骨髓增生异常综合征 (MDS) 中原始细胞表型的了解很有价值，但仍然很少。这主要是因为MDS母细胞在临床样本中只占少数，导致分析困难。因此，对于这项母细胞表型研究，我们从 95 名不同 MDS 亚型患者和 21 名 MDS 转化的急性白血病 (AL-MDS) 患者的血液和骨髓样本中制备了富含母细胞的标本（使用新的密度离心试剂收集母细胞）。流式细胞术显示，几乎所有患者的高比例富集母细胞（EBC）均表现出定型骨髓前体细胞（CD34（+）CD38（+）HLA-DR（+）CD13（+）CD33（+））的免疫表型，无论疾病亚型如何。 58% 的病例中髓过氧化物酶的细胞化学反应呈阴性。因此，MDS 中的 EBC 表型比新发急性髓系白血病中更不成熟。 MDS EBC 通常异步共表达干细胞抗原和晚期骨髓抗原，但很少表达 T 和 B 淋巴细胞特异性抗原。骨髓细胞成熟标记（CD10 和 CD15）在低危 MDS（难治性贫血 [RA] 和伴环状铁粒幼细胞的 RA）EBC 中更为常见，而髓系细胞不成熟标记（CD7 和 CD117）在高危 MDS（慢性粒单核细胞白血病、原始细胞过多的 RA [RAEB] 和 RAEB）中更为常见。转换）和 AL-MDS。通过对同一患者进行连续表型分析，还记录了伴随疾病进展而发生的 EBC 向更不成熟表型的转变。此外，EBC 的 CD7 阳性是 MDS 预后不良的独立变量。这些数据代表了有关 MDS 的新的、有价值的信息。 (C) 2002 年，美国血液学会。
Knowledge of the blast phenotype in myelodysplastic syndrome (MDS) would be valuable, as in other malignancies, but remains sparse. This is mainly because MDS blasts are a minor population in clinical samples, making analysis difficult. Thus, for this blast phenotype study, we prepared blast-rich specimens (using a new density centrifugation reagent for harvesting blasts) from blood and marrow samples of 95 patients with various MDS subtypes and 21 patients with acute leukemia transformed from MDS (AL-MDS). Flow cytometry revealed that a high proportion of the enriched blast cells (EBCs) from almost all patients showed an immuno-phenotype of committed myeloid precursors (CD34(+)CD38(+)HLA-DR(+)CD13(+)CD33(+)), regardless of the disease subtype. The cytochemical reaction for myeloperoxidase was negative in 58% of the cases. Thus, the EBC phenotype is more immature in MDS than in de novo acute myeloid leukemia. MDS EBCs often coexpressed stem cell antigens and late-stage myeloid antigens asynchronously, but rarely expressed T- and B-lymphoid cell-specific antigens. Markers for myeloid cell maturation (CD10 and CD15) were more prevalent on EBCs from low-risk MDS (refractory anemia [RA] and RA with ringed sideroblasts), whereas markers for myeloid cell immaturity (CD7 and CD117) were more prevalent on EBCs from highrisk MDS (chronic myelomonocytic leukemia, RA with excess blasts [RAEB], and RAEB in transformation) and AL-MDS. A shift to a more immature phenotype of EBCs, accompanying disease progression, was also documented by sequential phenotyping of the same patients. Further, CD7 positivity of EBCs was an independent variable for a poor prognosis in MDS. These data represent new, valuable information regarding MDS. (C) 2002 by The American Society of Hematology.