Document Detail

Additional prognostic value of bone marrow histology in patients subclassified according to the International Prognostic Scoring System for myelodysplastic syndromes.
MedLine Citation:
PMID:  12525519     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The most recent and powerful prognostic instrument established for myelodysplastic syndromes (MDS) is the International Prognostic Scoring System (IPSS), which is primarily based on medullary blast cell count, number of cytopenias, and cytogenetics. Although this prognostic system has substantial predictive power in MDS, further refinement is necessary, especially as far as lower-risk patients are concerned. Histologic parameters, which have long proved to be associated with outcome, are promising candidates to improve the prognostic accuracy of the IPSS. Therefore, we assessed the additional predictive power of the presence of abnormally localized immature precursors (ALIPs) and CD34 immunoreactivity in bone marrow (BM) biopsies of MDS patients. PATIENTS AND METHODS: Cytogenetic, morphologic, and clinical data of 184 MDS patients, all from a single institution, were collected, with special emphasis on the determinants of the IPSS score. BM biopsies of 173 patients were analyzed for the presence of ALIP, and CD34 immunoreactivity was assessable in 119 patients. Forty-nine patients received intensive therapy. RESULTS: The presence of ALIP and CD34 immunoreactivity significantly improved the prognostic value of the IPSS, with respect to overall as well as leukemia-free survival, in particular within the lower-risk categories. In contrast to the IPSS, both histologic parameters also were predictive of outcome within the group of intensively treated MDS patients. CONCLUSION: Our data confirm the importance of histopathologic evaluation in MDS and indicate that determining the presence of ALIP and an increase in CD34 immunostaining in addition to the IPSS score could lead to an improved prognostic subcategorization of MDS patients.
E Verburgh; R Achten; B Maes; A Hagemeijer; M Boogaerts; C De Wolf-Peeters; G Verhoef
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  21     ISSN:  0732-183X     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-01-14     Completed Date:  2003-02-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  273-82     Citation Subset:  IM    
Department of Hematology, University Hospitals, University of Leuven, Leuven, Belgium.
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MeSH Terms
Aged, 80 and over
Antigens, CD34 / metabolism
Bone Marrow / metabolism,  pathology*
Cytogenetic Analysis
Immunoenzyme Techniques
Middle Aged
Myelodysplastic Syndromes / classification,  diagnosis*,  metabolism
Neoplasm Staging
Risk Factors
Survival Rate
Reg. No./Substance:
0/Antigens, CD34

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