Mesenchymal stromal cell density is increased in higher grade myelodysplastic syndromes and independently predicts survival.
OBJECTIVE
We retrospectively tested the prognostic and diagnostic significance of CD271+ mesenchymal stromal cell (MSC) density in cytopenic patients who underwent bone marrow biopsy to evaluate for myelodysplastic syndromes (MDS).


METHODS
CD271+ MSC density was quantitated by automated image analysis of tissue microarray cores in 125 cytopenic patients: 40 lower grade MDS (<5% marrow blasts), 24 higher grade MDS, and 61 benign.


RESULTS
CD271+ MSC density was increased in higher grade MDS compared with benign (P = .006) and lower grade MDS (P = .02). CD271+ MSC density was predictive of survival among patients with MDS independent of Revised International Prognostic Scoring System (IPSS-R), history of transfusion, therapy-related MDS, and fibrosis (hazard ratio, 3.4; P < .001). Among low or intermediate IPSS-R patients, median survival was significantly shorter in the high CD271+ MSC density group (47 vs 18 months, P < .02).


CONCLUSIONS
High CD271+ MSC density is characteristic of higher grade MDS and is associated with poor risk independent of known prognostic factors.
From the Department of Pathology, Stanford University School of Medicine, Stanford, CA, and.
Ryan C
RC
Johnson
From the Department of Pathology, Stanford University School of Medicine, Stanford, CA, and.
Jason H
JH
Kurzer
Hematology Division, Stanford University Cancer Center, Stanford, CA.
Peter L
PL
Greenberg
From the Department of Pathology, Stanford University School of Medicine, Stanford, CA, and ditag@stanford.edu.
Dita
D
Gratzinger
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D059630:Mesenchymal Stem Cells / Q000473:pathology*; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality* / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D046888:Tissue Array Analysis
CD271; Cytopenias; IPSS-R; Mesenchymal stromal cells; Myelodysplastic syndromes