Immunohematological findings in myelodysplastic syndrome.
BACKGROUND
Few immunohematological studies have been done in myelodysplastic syndrome (MDS).


METHODS
Twenty-nine MDS patients were retrospectively evaluated with a direct antiglobulin test (DAT), antibody screening, serum electrophoresis and immunoelectrophoresis. Clinical and laboratory studies (hemoglobin level, reticulocyte count, DHL, total and indirect bilirubin) were done simultaneously, as well as the French-American-British subtype and bone marrow biopsy findings.


RESULTS
Alloantibodies were demonstrated in 17 patients (58.6%), autoantibodies in 10 (34.4%) patients and cold agglutinin in 18 (62%) patients. DAT was mediated by only IgG in 8 patients (80%), by IgG and C3 in 1 patient (10%) and by IgG, IgA and C3 in 1 (10%) patient. No hemolytic disease occurred in patients with autoantibodies. Increased serum gammaglobulin was observed in 16 (54.4%) patients. There was no correlation between the incidence of allo-/autoantibodies and the gammaglobulin level (p = 0.937) and the presence of lymphocyte infiltrates in bone marrow biopsies (p = 0.156). No significant difference was observed when the incidence of autoantibodies and number of red blood cell transfusions were compared (p = 0.334). Patients with refractory anemia and refractory anemia with ringed sideroblasts subtypes had a higher incidence of allo-/autoantibodies than other MDS subtypes (p = 0.03).


CONCLUSIONS
Patients with MDS, in particular refractory anemia and refractory anemia with ringed sideroblasts have a high incidence of allo- and autoantibodies, probably related to intrinsic immune disorder, without clinical or laboratory hemolysis.
Novaretti
M C
MC
Hematology and Hemotherapy Deparment, University of São Paulo, School of Medicine, Fundação Pró-Sangue/Hemocentro de São Paulo, Av. Dr Enéas de Carvalho Aguiar, 155-1. andar São Paulo, Brazil. marcia.novaretti@uol.com.br
Sopelete
C R
CR
Velloso
E R
ER
Rosa
M F
MF
Dorlhiac-Llacer
P E
PE
Chamone
D A
DA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000373:Agglutinins / Q000097:blood; D000753:Anemia, Refractory / Q000276:immunology; D000754:Anemia, Refractory, with Excess of Blasts / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D003176:Complement C3 / Q000032:analysis; D003298:Coombs Test; D003450:Cryoglobulins; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D007122:Immunoelectrophoresis; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007518:Isoantibodies / Q000097:blood; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000276:immunology* / Q000473:pathology; D012189:Retrospective Studies
D000373:Agglutinins; D001323:Autoantibodies; D003176:Complement C3; D003450:Cryoglobulins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007518:Isoantibodies; C029443:cold agglutinins