Document Detail

Evaluation of apoptosis as a prognostic factor in myelodysplastic syndromes.
MedLine Citation:
PMID:  10997968     Owner:  NLM     Status:  MEDLINE    
The myelodysplastic syndromes (MDS) are a group of disorders characterized by peripheral pancytopenia despite normo- or hypercellular bone marrow. This is thought to be as a result of the apoptosis of haematopoietic bone marrow cells resulting in ineffective haematopoiesis. To clarify the relationship between prognosis and apoptosis and/or cell proliferation in the bone marrow, we studied 51 cases with MDS. Bone marrow biopsies were stained immunohistochemically for MIB-1 (marker for proliferating cells) and CD34 (marker for stem cells). Apoptosis was visualized by detection of DNA fragmentation using TdT incorporation of nucleotides on 3' ends of DNA (TUNEL technique) and expressed as the apoptotic rate. MDS patients included 32 with refractory anaemia (RA), one RA with ringed sideroblasts (RARS) patient, seven RA with excess of blasts (RAEB) patients, eight patients with RAEB in transformation (RAEB-t) and three patients with chronic myelomonocytic leukaemia (CMMoL). In addition, we also studied six cases with acute myeloid leukaemia (AML) arising from MDS (AML-MDS) and ten control subjects. Fatal pancytopenia was the cause of death in 19 out of 51 patients. The apoptotic rate was higher in MDS patients (5.5%) than in control subjects (0.6%) and AML-MDS patients (0.4%). The percentage of MIB-1 positive cells was higher in MDS and AML-MDS than in control. The percentage of CD34-positive cells was higher in AML-MDS, RAEB, RAEB-t and CMMoL patients than control subjects and RA patients. Our findings indicate the activation of both the proliferative and apoptotic rates in MDS. Poor prognosis correlated significantly with higher apoptotic rates, but not with percentages of MIB-1 and CD34-positive cells. Our results suggest that apoptosis might be a useful prognostic factor and inhibition of apoptotic mechanisms may induce leukaemic transformation in MDS.
K Shimazaki; K Ohshima; J Suzumiya; C Kawasaki; M Kikuchi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of haematology     Volume:  110     ISSN:  0007-1048     ISO Abbreviation:  Br. J. Haematol.     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-10-10     Completed Date:  2000-10-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372544     Medline TA:  Br J Haematol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  584-90     Citation Subset:  IM    
Department of Pathology, School of Medicine, Fukuoka University, Fukuoka, Japan.
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MeSH Terms
Aged, 80 and over
Antigens, CD34 / analysis
Antigens, Nuclear
Biological Markers / analysis
Bone Marrow Cells / pathology*
Evaluation Studies as Topic
In Situ Nick-End Labeling
Ki-67 Antigen
Leukemia, Myeloid / mortality,  pathology
Middle Aged
Myelodysplastic Syndromes / mortality,  pathology*
Nuclear Proteins / analysis
Survival Rate
Reg. No./Substance:
0/Antigens, CD34; 0/Antigens, Nuclear; 0/Biological Markers; 0/Ki-67 Antigen; 0/Nuclear Proteins

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