title: Angiogenesis in relation to clinical stage, apoptosis and prognostic score in myelodysplastic syndromes.
abstract: The International Prognostic Scoring System (IPSS), based on the number of cytopenias, percentage of bone marrow blasts and cytogenetics, is an important prognostic tool for patients with myelodysplastic syndrome (MDS). In addition, factors such as high bone marrow cellularity and lactate dehydrogenase levels have been associated with an adverse outcome, spontaneously and after chemotherapy. Recently, increased bone marrow angiogenesis, measured as, e.g. microvascular density (MVD), was reported to be more intense in high-risk than in low-risk MDS. To assess the prognostic role of MVD in MDS, a cohort of 56 patients, thoroughly investigated for various clinical and morphological parameters, were followed-up for survival > or =60 months after the diagnostic analysis. As a group MDS patients had higher MVD compared to healthy controls (p<0.02). The highest median MVD value was observed in the RAEB group, but there was no overall significant difference between the FAB groups. No significant correlations were observed between MVD and peripheral blood counts, bone marrow cellularity, percentage of bone marrow blasts and CD34 positive cells, apoptotic index (TUNEL), proliferation index (MIB-1), erythroid index, FAB group and IPSS score. MVD was not correlated to overall survival. In contrast, bone marrow blast count <5%, low or normal cellularity, as well as a high erythroid index, indicated a favorable survival. Thus, our data do not support an important prognostic role of angiogenesis, reflected by microvessel density, in the myelodysplastic syndromes.
authors.affiliation: Department of Medicine, Stockholm Söder Hospital, The Karolinska Institutet, SE-141 86 Stockholm, Sweden.
authors.forename: Lars Göran
authors.initials: LG
authors.lastname: Lundberg
authors.forename: Eva
authors.initials: E
authors.lastname: Hellström-Lindberg
authors.forename: Lena
authors.initials: L
authors.lastname: Kanter-Lewensohn
authors.forename: Richard
authors.initials: R
authors.lastname: Lerner
authors.forename: Jan
authors.initials: J
authors.lastname: Palmblad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000097:blood; D017209:Apoptosis; D001752:Blast Crisis / Q000097:blood / Q000401:mortality / Q000473:pathology*; D001772:Blood Cell Count; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology*; D049109:Cell Proliferation; D015331:Cohort Studies; D018572:Disease-Free Survival; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D020287:In Situ Nick-End Labeling; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000401:mortality / Q000473:pathology*; D009389:Neovascularization, Pathologic / Q000097:blood / Q000401:mortality / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors
chemical_list: D018952:Antigens, CD34