Schrappe-Bächer M, Steffen H M, Maier M, Bernards P, Hoeffken A, Fätkenheuer G
Medizinische Klinik II, Universität Köln.
Med Klin (Munich). 1990 Sep 15;85(9):511-6.
38 patients diagnosed as myelodysplastic syndrome (MDS) were retrospectively evaluated for clinical course, prognostic factors, diagnostical power of cytology and histology and relevance of hypoplastic myelodysplastic syndrome. Median observation time was 14.5 (0 to 104) months. 15 patients (40%) developed an acute myelogenous leukemia after two to 67 (median eleven) months. Prognosis was negatively influenced by age, suggested myelotoxic agents in prior history and leukemia in first-grade relatives as well as ESR greater than or equal to 30 mm Hg (first hour). FAB-classification and Bournemouth-score reflected prognosis in respect to survival time and development of an acute leukemia. Cytology and histology revealed contradictory results in four of 14 comparable cases (28.6%). Hypoplastic myelodysplastic syndrome was diagnosed by histology in seven out of eight cases. This entity showed significantly lower WBC-values and a considerable longer survival time.
对38例诊断为骨髓增生异常综合征（MDS）的患者进行回顾性评估，分析其临床病程、预后因素、细胞学和组织学诊断效能以及低增生性骨髓增生异常综合征的相关性。中位观察时间为14.5（0至104）个月。15例患者（40%）在2至67（中位11）个月后发生急性髓系白血病。年龄、既往有骨髓毒性药物使用史、一级亲属中有白血病以及血沉（ESR）≥30 mmHg（第1小时）对预后有负面影响。FAB分类和伯恩茅斯评分在生存时间和急性白血病发生方面反映了预后情况。在14例可比较病例中的4例（28.6%），细胞学和组织学结果相互矛盾。8例中有7例通过组织学诊断为低增生性骨髓增生异常综合征。该类型患者白细胞值显著较低，生存时间明显更长。
