title: Ringed sideroblasts in primary myelodysplasia. Leukemic propensity and prognostic factors.
abstract: Among 123 patients with ringed sideroblasts on bone marrow aspirates, 85 had acquired ringed sideroblasts with primary myelodysplasia. The patients were placed in categories modified from the French-American-British classification based on percentages of ringed sideroblasts and myeloblasts in the initial bone marrow. Overall, 48% (41/85) of patients with myelodysplasia developed acute leukemia. Primary acquired sideroblastic anemia was the most favorable category with longer survival and 13.8% (4/29) leukemic conversions. Variables correlating with leukemic transformation included male sex, thrombocytopenia, neutropenia, and pseudo-Pelger-Huët neutrophils. Only two variables had independent predictive value by multivariate regression analysis: a high percentage of myeloblasts and a low percentage of ringed sideroblasts. Numerous ringed sideroblasts strongly predicts a more favorable course in myelodysplastic patients.
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, TX.
authors.forename: L
authors.initials: L
authors.lastname: Vandermolen
authors.forename: L
authors.initials: L
authors.lastname: Rice
authors.forename: M A
authors.initials: MA
authors.lastname: Rose
authors.forename: E C
authors.initials: EC
authors.lastname: Lynch
mesh_terms: D000208:Acute Disease; D000368:Aged; D000756:Anemia, Sideroblastic / Q000097:blood / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D001853:Bone Marrow / Q000473:pathology*; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D005260:Female; D006801:Humans; D007938:Leukemia / Q000473:pathology*; D008297:Male; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors