[Refractory anemia and preleukemia: an analysis of 92 cases].

OBJECTIVE

To investigate the relationship between MDS-RA (refractory anemia subtype of myelodysplastic syndromes) and preleukemia (PL).

METHODS

Hematological parameters of 86 RA and 6 PL patients were retrospectively analyzed.

RESULTS

Thirty-four RA cases (39.53%) transformed into acute leukemia (AL), RA with excess blasts (RAEB), or RAEB in transformation (RAEB-t). As compared with 52 non-transformed RA cases, the transformed cases showed the following hematological features: 1. higher frequencies of immature granulocytes (P < 0.005), erythroblasts (P < 0.05) and megaloerythrocytes (P < 0.05), and higher granulocyte nuclear lobulation (P < 0.001) in peripheral blood; 2. higher percentages of early erythroid and granulocytic lineages (P < 0.05), and higher frequencies of erythroblasts with multiple nuclei (P < 0.05), pseudo Pelger-Huet abnormality (P < 0.05), and micromegakaryocytes (P < 0.005) in bone marrow.

CONCLUSION

There is a higher overlap between RA and PL; the above hematological features may be useful for predicting the transformation of RA patients. Based on those findings, a score system for predicting the transformation of RA was proposed.