骨髓增生异常综合征集落形成细胞的体外特性分析及其与非重型再生障碍性贫血的比较

[Analysis of in vitro characteristics of colony-forming cells in myelodysplastic syndrome and comparison with that in non-severe aplastic anemia].

作者信息

Zhang Tian-jiao, Feng Min, Zheng Yi-zhou, Li Xing-xin, Xu Ze-feng, Qin Tie-jun, Zhang Yue, Yang Yu-bao, Liu Jun-xia, Ren Yan-song, Xiao Zhi-jian

机构信息

Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, State Key Laboratory of Experimental Hematology, Tianjin 300020, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2012 Jul;33(7):516-21.

PMID:22967409

Abstract

OBJECTIVE

To investigate in vitro characteristics of colony-forming cells (CFC) in patients with myelodysplastic syndrome (MDS) and to compare that in patients with non-severe aplastic anemia (NSAA).

METHODS

Data of in vitro CFC and correlation with other related laboratory tests in 155 newly diagnosed MDS patients were analyzed retrospectively, and to compare with data of in vitro CFC in 122 newly diagnosed NSAA patients.

RESULTS

Median number of burst-forming units-erythroid (BFU-E) was 9 (0 - 157)/10(5) bone marrow mononuclear cells (BMMNC), colony forming unit-erythroid (CFU-E) 30 (0 - 425)/10(5)BMMNC and colony forming unit-granulocytes/macrophages (CFU-GM) 14 (0 - 125)/10(5)BMMNC in patients with MDS, being significantly lower than those in healthy control; number of BFU-E and/or CFU-E was lower than the lower limit of normal control in 66 cases (42.6%), CFU-GM lower in 3 cases (1.9%) and BFU-E and/or CFU-E with CFU-GM lower in 70 cases (45.2%). Cluster/CFU-GM ratio was significantly lower in low blast group (MDS < 5% blast in bone marrow smear) than that in high blast group (MDS ≥ 5% blast) (0.65 vs 1.0, P = 0.049). In all MDS patients, cluster had positive correlation with each type of CFC (r = 0.415, 0.338, 0.642 for BFU-E, CFU-E, CFU-GM, respectively, P = 0.000), but had negative correlation with neutrophil alkaline phosphatase (N-ALP) positive rate and scores (r(rate) = -0.315, P = 0.001 and r(scores) = -0.257, P = 0.006). The median number of each type of CFC was significantly higher in MDS group than that in NSAA group (BFU-E 9 vs 5/10(5)BMMNC, P = 0.017; CFU-E 30 vs 19.5/10(5)BMMNC, P = 0.023; CFU-GM 14 vs 10/10(5)BMMNC, P = 0.003, respectively). Positive correlation between BFU-E and CFU-E were revealed in both MDS and NSAA group (r(MDS) = 0.712, P = 0.000 and r(NSAA) = 0.757, P = 0.000), with a lower correlation coefficient in MDS (P < 0.05).

CONCLUSIONS

Early onset MDS present markedly decreased hematopoietic progenitor cells (HPC), and particularly in erythroid progenitors extensively and severely. The number of BFU-E, CFU-E and CFU-GM can reflect HPC number in vivo but not stand for normal hematopoietic clones, the number of clusters represent pathologic HPC clones but not exactly leukemic blasts.

摘要

目的

研究骨髓增生异常综合征（MDS）患者集落形成细胞（CFC）的体外特征，并与非重型再生障碍性贫血（NSAA）患者进行比较。

方法

回顾性分析155例新诊断MDS患者的体外CFC数据及其与其他相关实验室检查的相关性，并与122例新诊断NSAA患者的体外CFC数据进行比较。

结果

MDS患者红系爆式集落形成单位（BFU-E）中位数为9（0～157）/10⁵骨髓单个核细胞（BMMNC），红系集落形成单位（CFU-E）为30（0～425）/10⁵BMMNC，粒-巨噬系集落形成单位（CFU-GM）为14（0～125）/10⁵BMMNC，均显著低于健康对照；66例（42.6%）患者BFU-E和/或CFU-E低于正常对照下限，3例（1.9%）患者CFU-GM低于正常对照下限，70例（45.2%）患者BFU-E和/或CFU-E及CFU-GM均低于正常对照下限。低原始细胞组（骨髓涂片原始细胞＜5%的MDS患者）的集簇/CFU-GM比值显著低于高原始细胞组（骨髓涂片原始细胞≥5%的MDS患者）（0.65对1.0，P = 0.049）。在所有MDS患者中，集簇与各类型CFC均呈正相关（BFU-E、CFU-E、CFU-GM的r值分别为0.415、0.338、0.642，P = 0.000），但与中性粒细胞碱性磷酸酶（N-ALP）阳性率及积分呈负相关（r(阳性率)= -0.315，P = 0.001；r(积分)= -0.257，P = 0.006）。MDS组各类型CFC中位数均显著高于NSAA组（BFU-E：9对5/10⁵BMMNC，P = 0.017；CFU-E：30对19.5/10⁵BMMNC，P = 0.023；CFU-GM：14对10/10⁵BMMNC，P = 0.003）。MDS组和NSAA组BFU-E与CFU-E均呈正相关（r(MDS)= 0.712，P = 0.000；r(NSAA)= 0.757，P = 0.000），MDS组相关系数较低（P＜0.05）。