title: Quantitative analysis of bone marrow CD34 cells in aplastic anemia and hypoplastic myelodysplastic syndromes.
abstract: Aplastic anemia (AA) and hypoplastic myelodysplastic syndromes (hMDS) are often difficult to distinguish. However, an accurate diagnosis is important because the prognosis and treatment of these diseases may differ. CD34+ hematopoietic progenitors are central to the pathogenesis of both disorders; they are the targets of the autoimmune attack in AA and neoplastic transformation in MDS. The aim of this study was to assess whether bone marrow CD34+ cell numbers could be used in differentiating between AA and hMDS. The percentage of bone marrow CD34+ cells was normal or increased (mean -3.5+0.5%, range 1-7%) in 15 of 35 patients studied, and low (mean -0.13 +/- 0.02%, range 0.02-0.36%) in 20 of 35 patients. All patients with a normal or increased percentage of CD34+ cells were ultimately diagnosed with hMDS based on the detection of clonal cytogenetic abnormalities or progression to refractory anemia with excess blasts/acute myeloid leukemia. All patients with low marrow CD34+ cell numbers met standard clinical criteria for AA and have not demonstrated neoplastic transformation with follow-up. Quantification of marrow CD34+ cells may serve as an important tool for distinguishing between AA and hMDS.
authors.affiliation: The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA. matsuwi@jhmi.edu
authors.forename: W H
authors.initials: WH
authors.lastname: Matsui
authors.forename: R A
authors.initials: RA
authors.lastname: Brodsky
authors.forename: B D
authors.initials: BD
authors.lastname: Smith
authors.forename: M J
authors.initials: MJ
authors.lastname: Borowitz
authors.forename: R J
authors.initials: RJ
authors.lastname: Jones
mesh_terms: D000328:Adult; D000741:Anemia, Aplastic / Q000276:immunology*; D018952:Antigens, CD34 / Q000276:immunology*; D001854:Bone Marrow Cells / Q000276:immunology*; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000276:immunology*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D018952:Antigens, CD34