Protein 4.1 deficiency and deletion of chromosome 20q are associated with acquired elliptocytosis in myelodysplastic syndrome.
We report a case of myelodysplastic syndrome (MDS), associated with prominent elliptocytosis. A 66-year-old male presented with peripheral pancytopenia, and was diagnosed with MDS [refractory anaemia (RA)]. Apart from marked elliptocytosis, dyshaematopoietic features were not evident in his peripheral blood or hypercellular bone marrow. After 18 months, he had progressed to RA with excess blasts in transformation. Analysis of red blood cell membrane proteins by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) showed a reduced quantity of protein 4.1 (30% of control). Deletion of chromosome 20q was identified by conventional cytogenetic analysis and fluorescence in situ hybridization. Marked elliptocytosis, persistent for more than 17 months, decreased strikingly after chemotherapy with idarubicin and Ara-C. These findings suggest that acquired elliptocytosis occurred as an unusual morphological feature of MDS, associated with abnormalities of protein 4.1 and chromosome 20q.
Hur
M
M
Department of Laboratory Medicine, Hallym University College of Medicine, Seoul, Korea.
Lee
K M
KM
Cho
H C
HC
Park
Y I
YI
Kim
S H
SH
Chang
Y W
YW
Kim
Y R
YR
Cho
H I
HI
D000368:Aged; D000753:Anemia, Refractory / Q000209:etiology / Q000235:genetics; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D002872:Chromosome Deletion; D002890:Chromosomes, Human, Pair 20 / Q000235:genetics*; D003561:Cytarabine / Q000627:therapeutic use; D003598:Cytoskeletal Proteins / Q000235:genetics*; D004612:Elliptocytosis, Hereditary / Q000209:etiology / Q000235:genetics / Q000473:pathology; D004912:Erythrocytes / Q000473:pathology*; D006801:Humans; D015255:Idarubicin / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008565:Membrane Proteins / Q000235:genetics*; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000235:genetics*; D010198:Pancytopenia / Q000209:etiology / Q000235:genetics
D000903:Antibiotics, Antineoplastic; D003598:Cytoskeletal Proteins; D007166:Immunosuppressive Agents; D008565:Membrane Proteins; C028841:erythrocyte membrane band 4.1 protein; D003561:Cytarabine; D015255:Idarubicin