title: Correlation between immunological abnormalities and prognosis in myelodysplastic syndrome patients.
abstract: Immunological abnormalities (IA) are frequently observed in patients with myelodysplastic syndromes (MDS). Although there have been a number of analyses of the prognostic factors, there have been few studies, if any, to determine whether IA affects prognosis. We investigated the prognosis of 153 MDS patients with or without IA who were treated at a single Japanese institute for 10 years. Nineteen of 153 patients (12%) developed autoimmune disorders. One hundred of 153 patients (63%) had an abnormality in at least one immunological laboratory test. Hypergammaglobulinemia was found in 50 of 128 (39%) patients tested, hypogammaglobulinemia was observed in 10 of 128 (8%), positivities of antinuclear antibody, RA factor. DNA antibody, and direct antiglobulin test were observed in 30%, 14%, 7% and 12%, respectively, and a CD4/CD8 ratio < 1 was observed in 20%. There was no significance in the distribution of age, MDS subtype, or sex between patients with and without IA. The survival of MDS patients without IA was significantly better than that of patients with IA, and the survival of patients with a CD4/CD8 ratio > 1 was also significantly superior to the survival of those with an inverted CD4/CD8 ratio. Patients with IA tended to die of infection or leukemic progression in comparison with those without IA, suggesting that IA may be associated with susceptibility to opportunistic infection and disease progression.
authors.affiliation: Second Department of Internal Medicine, Hyogo College of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Okamoto
authors.forename: M
authors.initials: M
authors.lastname: Okada
authors.forename: A
authors.initials: A
authors.lastname: Mori
authors.forename: K
authors.initials: K
authors.lastname: Saheki
authors.forename: H
authors.initials: H
authors.lastname: Takatsuka
authors.forename: H
authors.initials: H
authors.lastname: Wada
authors.forename: A
authors.initials: A
authors.lastname: Tamura
authors.forename: Y
authors.initials: Y
authors.lastname: Fujimori
authors.forename: Y
authors.initials: Y
authors.lastname: Takemoto
authors.forename: A
authors.initials: A
authors.lastname: Kanamaru
authors.forename: E
authors.initials: E
authors.lastname: Kakishita
mesh_terms: D000328:Adult; D000361:Agammaglobulinemia / Q000276:immunology*; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D016516:CD4-CD8 Ratio; D005260:Female; D006801:Humans; D006942:Hypergammaglobulinemia / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000276:immunology*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D001323:Autoantibodies