title: Burden of abnormal hematopoietic clone in patients with myelodysplastic syndromes.
abstract: OBJECTIVE
  To investigate the role of the burden of abnormal hematopoietic clone in the development of myelodysplastic syndromes (MDS).
  
  
  METHODS
  The ratio of the bone marrow cells with abnormal chromosomes to the total counted bone marrow cells was regarded as the index of MDS clone burden. The disease severity related parameters including white blood cell count, hemoglobin, platelet count, lactate dehydrogenase level, bone marrow blast, myeloid differentiation index, micromegakaryocyte, transfusion, interleukin-2, tumor necrosis factor (TNF), CD4+ and CD8+ T cells of MDS patients were assayed, and the correlations between those parameters and MDS clone burden were also analyzed.
  
  
  RESULTS
  The clone burden of MDS patients was 67.4% +/- 36.2%. MDS clone burden positively correlated with bone marrow blasts (r = 0.483, P < 0.05), negatively with hemoglobin level (r = -0.445, P < 0.05). The number of blasts, hemoglobin, and erythrocytes in high clone burden (> 50%) and low clone burden ( < or = 50%) groups were 7.78% +/- 5.51% and 3.45% +/- 3.34%, 56.06 +/- 14.28 g/L and 76.40 +/- 24.44 g/L, (1.82 +/- 0.48) x 10(12)/L and (2.32 +/- 0.66) x 10(12)/L, respectively (all P < 0.05). CD4+ T lymphocytes of MDS patients and normal controls were (0.274 +/- 0.719) x 10(9)/L and (0.455 +/- 0.206) x 10(9)/L, respectively (P < 0.05). CD8+ T lymphocytes of MDS patients and normal controls were (0.240 +/- 0.150) x 10(9)/L and (0.305 +/- 0.145) x 10(9)/L, respectively. The serum level of interleukin-2 of MDS patients (6.29 +/- 3.58 ng/mL) was significantly higher than normal control (3.11 +/- 1.40 ng/mL, P < 0.05). The serum level of TNF of MDS patients and normal control group were 2.42 +/- 1.79 ng/mL and 1.68 +/- 0.69 ng/mL, respectively. The ratio of CD4 to CD8 was higher in high clone burden MDS patients (1.90 +/- 0.52) than that in low clone burden patients (0.97 +/- 0.44, P < 0.05).
  
  
  CONCLUSIONS
  The quantitive clonal karyotype abnormalities and deficient T cell immunity are important parameters for evaluating MDS severity and predicting its progression.
authors.affiliation: First Department of Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020.
authors.forename: Hua-Quan
authors.initials: HQ
authors.lastname: Wang
authors.forename: Zong-Hong
authors.initials: ZH
authors.lastname: Shao
authors.forename: Jun
authors.initials: J
authors.lastname: Shi
authors.forename: Yan-Ran
authors.initials: YR
authors.lastname: Cao
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.forename: Jie
authors.initials: J
authors.lastname: Bai
authors.forename: Mei-Feng
authors.initials: MF
authors.lastname: Tu
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Xing
authors.forename: Zhen-Zhu
authors.initials: ZZ
authors.lastname: Cui
authors.forename: Shi-He
authors.initials: SH
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Sun
authors.forename: Hai-Rong
authors.initials: HR
authors.lastname: Jia
authors.forename: Tian-Ying
authors.initials: TY
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001854:Bone Marrow Cells / Q000473:pathology*; D016022:Case-Control Studies; D002869:Chromosome Aberrations; D005260:Female; D006410:Hematopoiesis / Q000235:genetics; D006412:Hematopoietic Stem Cells / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000235:genetics* / Q000473:pathology*; D014411:Neoplastic Stem Cells / Q000473:pathology; D011086:Polycythemia / Q000235:genetics / Q000473:pathology; D016176:T-Lymphocyte Subsets / Q000473:pathology; D055815:Young Adult