Prevalence and clinical characteristics of myelodysplastic syndrome with bone marrow eosinophilia or basophilia.
By retrospectively analyzing 288 patients with de novo myelodysplastic syndrome (MDS), we sought to determine the prevalence and clinical characteristics of bone marrow eosinophilia and basophilia that were detected at presentation. Bone marrow eosinophilia and basophilia were defined as a differential count of each cell type exceeding 5.0% and 1.0%, respectively. Of 288 patients with MDS, 36 (12.5%) fulfilled this criterion for bone marrow eosinophilia (MDS-Eos); 34 patients (11.8%) showed basophilia (MDS-Bas), and 11 (3.8%) satisfied both criteria (MDS-EosBas). The remaining 229 patients had neither eosinophilia nor basophilia in their bone marrow (MDS(-/-)) at presentation. Cytogenetic analysis was carried out on unstimulated bone marrow cells obtained from 264 patients. When the cytogenetic categorization of the IPSS (International Prognostic Scoring System) for MDS was applied, significantly higher numbers of MDS-Eos and MDS-Bas patients had chromosomal abnormalities carrying intermediate or poor prognosis, compared with the MDS(-/-) patients. Specific chromosomal abnormalities and complex karyotypes were associated with MDS-Eos and/or MDS-Bas. In accordance with these results, the overall survival rate was significantly lower, and the evolution to acute myelogenous leukemia (AML) occurred more frequently in the MDS-Eos and MDS-Bas than in the MDS(-/-) patients. Multivariate analysis demonstrated that bone marrow basophilia was an independent risk factor for evolution to AML. Our study indicates that bone marrow eosinophilia and basophilia in patients with MDS predict a poorer prognosis.
Matsushima
Takafumi
T
Third Department of Internal Medicine, Gunma University School of Medicine, Maebashi, Japan. tmatsu@showa.gunma-u.ac.jp
Handa
Hiroshi
H
Yokohama
Akihiko
A
Nagasaki
Jun
J
Koiso
Hiromi
H
Kin
Yoshitora
Y
Tanaka
Yoko
Y
Sakura
Tohru
T
Tsukamoto
Norifumi
N
Karasawa
Masamitsu
M
Itoh
Katsuhiko
K
Hirabayashi
Hisami
H
Sawamura
Morio
M
Shinonome
Shogo
S
Shimano
Shun-ichi
S
Miyawaki
Shuichi
S
Nojima
Yoshihisa
Y
Murakami
Hirokazu
H
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001491:Basophils / Q000473:pathology*; D001853:Bone Marrow / Q000473:pathology*; D002869:Chromosome Aberrations; D018450:Disease Progression; D004802:Eosinophilia / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007951:Leukemia, Myeloid / Q000453:epidemiology; D007958:Leukocyte Count; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000145:classification / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D015996:Survival Rate