title: Dyspoietic changes associated with hepatosplenic T-cell lymphoma are not a manifestation of a myelodysplastic syndrome: analysis of 25 patients.
abstract: Hepatosplenic T-cell lymphoma (HSTCL) is a rare T-cell lymphoma commonly associated with cytopenias. The pathogenesis of cytopenias in patients with HSTCL is not well defined, although the presence of dyspoietic hematopoietic cells and the common association with trisomy 8 raise the possibility of an associated myelodysplastic syndrome (MDS). In 25 bone marrow specimens involved by HSTCL, we systematically assessed for morphologic features of dyspoiesis and correlated the findings with peripheral cytopenia(s), cytogenetic findings, and detection of chromosome 8 by fluorescence in situ hybridization. The median patient age was 33 years. One patient had a history of MDS diagnosed 1 year prior to the diagnosis of HSTCL. Thirteen (54%) patients had anemia less than 100 g/L, 10 (53%) of 19 had neutropenia less than 1.8 × 10(9)/L, and 15 (60%) had thrombocytopenia less than 100 × 10(9)/L. Dyspoietic features were identified in 1 to 3 hematopoietic cell lineages in 20 (80%) of 25 patients. Cytogenetic analysis identified trisomy 8 in 7 cases. Patients with trisomy 8 had a lower platelet count, but trisomy 8 was not associated with cytopenias, dyspoietic features, or cytogenetic abnormalities. Combined morphologic and fluorescence in situ hybridization analysis showed that trisomy 8 was restricted to the lymphoma cells, except in the 1 patient with a history of MDS. In conclusion, dyspoietic changes are common in the bone marrow of patients with HSTCL. These changes are not associated with cytopenias or chromosomal abnormalities, suggesting that dyspoiesis in patients with HSTCL is not a manifestation of a MDS.
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Mariko
authors.initials: M
authors.lastname: Yabe
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: L Jeffrey
authors.initials: LJ
authors.lastname: Medeiros
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Guilin
authors.initials: G
authors.lastname: Tang
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Sa A
authors.initials: SA
authors.lastname: Wang
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Keyur
authors.initials: K
authors.lastname: P Patel
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Mark
authors.initials: M
authors.lastname: Routbort
authors.affiliation: Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY 10032.
authors.forename: Govind
authors.initials: G
authors.lastname: Bhagat
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Bueso-Ramos
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Jorgensen
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Rajyalakshmi
authors.initials: R
authors.lastname: Luthra
authors.affiliation: Department of Pathology, UT Southwestern Medical Center, Dallas, TX 75390.
authors.forename: Weina
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Tariq
authors.initials: T
authors.lastname: Muzzafar
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Kanagal-Shamanna
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Khoury
authors.affiliation: Department of Hematopathology, Dr Daneshbod Pathobiology Laboratory, Shiraz, Iran.
authors.forename: Yahya
authors.initials: Y
authors.lastname: Daneshbod
authors.affiliation: Department of Pathology, Bahman Hospital, Tehran, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Davanlou
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Shaoying
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030.
authors.forename: Ken H
authors.initials: KH
authors.lastname: Young
authors.affiliation: Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030. Electronic address: Roberto.miranda@mdanderson.org.
authors.forename: Roberto N
authors.initials: RN
authors.lastname: Miranda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics; D001853:Bone Marrow / Q000473:pathology*; D001856:Bone Marrow Examination; D002648:Child; D002675:Child, Preschool; D002898:Chromosomes, Human, Pair 8 / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000150:complications* / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy; D018655:Lymphocyte Count; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications* / Q000235:genetics / Q000473:pathology; D009503:Neutropenia / Q000097:blood / Q000209:etiology* / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy; D010641:Phenotype; D010976:Platelet Count; D011379:Prognosis; D012307:Risk Factors; D013160:Splenic Neoplasms / Q000150:complications* / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy; D013921:Thrombocytopenia / Q000097:blood / Q000209:etiology* / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy; D013997:Time Factors; D014314:Trisomy / Q000235:genetics; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor
keywords: Fluorescence in situ hybridization (FISH); Hepatosplenic T-cell lymphoma; Myelodysplasia; Pancytopenia; Trisomy 8