title: Hypoplastic myelodysplastic syndromes can be distinguished from acquired aplastic anaemia by bone marrow stem cell expression of the tumour necrosis factor receptor.
abstract: It is often difficult to distinguish hypoplastic myelodysplastic syndrome (h-MDS) from acquired aplastic anaemia (AA), because of the considerable clinical, cytological and histological similarities between these two disorders. The distinction between AA and h-MDS is important because there is a higher risk of progression to acute leukaemia in patients with h-MDS compared with AA. Recent studies suggest that tumour necrosis factor-alpha (TNF-alpha) plays an important role in the development of AA. In order to determine the potential importance of TNF-alpha in the differential diagnosis of hypoplastic bone marrow (BM) disorders, we examined whether analysis ofTNF-receptor expression could be used as a tool to differentiate AA from h-MDS. Flow cytometric analysis revealed that BM stem cells (CD34+) from AA patients have markedly greater TNF receptor (R) 1 and TNFR2 expression than those from patients with MDS and h-MDS. We suggest that the BM stem cells with a high expression of TNFR in patients with AA may be potently sensitive to TNF-alpha stimulation of differentiation. Thus, we propose that quantification of TNFR expression in BM stem cellsmay be a useful method to distinguish AA from h-MDS.
authors.affiliation: First Department ofInternal Medicine, Gifu University School of Medicine, Gifu, Japan.
authors.forename: Senji
authors.initials: S
authors.lastname: Kasahara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hara
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Itoh
authors.forename: Kazuki
authors.initials: K
authors.lastname: Ando
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tsurumi
authors.forename: Michio
authors.initials: M
authors.lastname: Sawada
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yamada
authors.forename: Hiroo
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Hisataka
authors.initials: H
authors.lastname: Moriwaki
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000741:Anemia, Aplastic / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D015703:Antigens, CD / Q000032:analysis; D018952:Antigens, CD34; D015415:Biomarkers / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D018124:Receptors, Tumor Necrosis Factor / Q000032:analysis*; D047889:Receptors, Tumor Necrosis Factor, Type II; D013234:Stem Cells / Q000276:immunology / Q000378:metabolism*
chemical_list: D015703:Antigens, CD; D018952:Antigens, CD34; D015415:Biomarkers; D018124:Receptors, Tumor Necrosis Factor; D047889:Receptors, Tumor Necrosis Factor, Type II