Proposal for refining the definition of dysgranulopoiesis in acute myeloid leukemia and myelodysplastic syndromes.
Studies of morphology of myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) refer to the definitions produced by the French-American-British (FAB) group and by the World Health Organization expert group. To clarify some points regarding the dysgranulopoiesis that are still unclear we analyzed a series of 98 neutrophils from MDS patients with regard to granularity, nuclear segmentation, the appearance of the chromatin, the presence of giant neutrophils, and the presence of nuclear chromatin extensions. We found that cells with at least 2/3 reduction of the content of granules, Pelger-like neutrophils, dysplastic non-Pelger cells, neutrophils with abnormal clumping of the chromatin, and macropolycytes could be recognized as dysplastic and included in the 10% count recommended by these two classifications. In addition, we suggest that neutrophils with more than 4 nuclear projections could be recognized as a relevant dysplastic feature.
University of Rennes, France. Electronic address: jean.goasguen@univ-rennes1.fr.
Jean E
JE
Goasguen
University of Rochester, NY, USA.
John M
JM
Bennett
St Mary's Hospital campus of Imperial College, London, UK.
Barbara J
BJ
Bain
University of Minnesota, USA.
Richard
R
Brunning
Vall d'Hebron Hospital, Barcelona, Spain.
Maria-Teresa
MT
Vallespi
University of Nagasaki, Japan.
Masao
M
Tomonaga
Haematology Institute, Catholic University of Sacred Heart, Rome, Italy.
Gina
G
Zini
University of Rennes and INSERM-CIC P 0203, France.
Alain
A
Renault
D001854:Bone Marrow Cells / Q000473:pathology; D053144:Cell Nucleus Shape; D003594:Cytoplasmic Granules / Q000473:pathology; D006098:Granulocytes / Q000473:pathology* / Q000502:physiology; D006410:Hematopoiesis; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000145:classification* / Q000473:pathology*; D007958:Leukocyte Count / Q000592:standards; D019891:Leukopoiesis; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000145:classification* / Q000473:pathology*; D009504:Neutrophils / Q000473:pathology; D014944:World Health Organization
Clumping chromatin; Granulocytic dysplasia; Hypogranularity; Macropolycytes; Nuclear projections; Pelger