Haase D, Fonatsch C, Freund M, Wörmann B, Bodenstein H, Bartels H, Stollmann-Gibbels B, Lengfelder E
Zentrum Innere Medizin, Department of Hematology and Oncology, Georg-August-Universität, Göttingen, Germany.
Ann Hematol. 1995 Apr;70(4):171-87. doi: 10.1007/BF01700373.
Cytogenetic analyses were performed on 266 bone marrow and peripheral blood samples from 179 patients with myelodysplastic syndromes (MDS). According to the FAB classification, 42 patients presented with RA, 18 with RARS, 37 with RAEB, 22 with CMML, and 29 with RAEB-T. Nine patients showed a secondary MDS (S MDS). FAB classification was not available for 22 patients. Clonal karyotype anomalies were found in 92 patients (51.4%). Complex chromosome abnormalities occurred in 17 (18.5%) of them. An evolution of the karyotype was detected in 16 cases (17.4%). Cytogenetically independent cells or cell clones were found in eight patients. Nonclonal chromosome abnormalities were uncovered in 29 (16.2%) of the 179 MDS patients. Consecutive studies were performed in 48 patients and revealed a good correlation of initial karyotype and clinical course. The most frequent single anomalies were 5q- in 29 (31.5%), -7 in 22 (23.9%), trisomy 1q in 14 (15.2%), and +8 in 13 (14.1%) of 92 patients respectively. Our cytogenetic findings are presented in detail and discussed in relation to patients' age, morphological classification, clinical course, and prognostic impact. The contribution of cytogenetic findings to the delineation of multistep pathogenesis of MDS with special emphasis to karyotype instability is demonstrated.
对179例骨髓增生异常综合征(MDS)患者的266份骨髓和外周血样本进行了细胞遗传学分析。根据FAB分类,42例患者表现为RA,18例为RARS,37例为RAEB,22例为CMML,29例为RAEB-T。9例患者表现为继发性MDS(S MDS)。22例患者无法进行FAB分类。92例患者(51.4%)发现克隆性核型异常。其中17例(18.5%)出现复杂染色体异常。16例(17.4%)检测到核型演变。8例患者发现细胞遗传学上独立的细胞或细胞克隆。179例MDS患者中有29例(16.2%)发现非克隆性染色体异常。对48例患者进行了连续研究,结果显示初始核型与临床病程具有良好的相关性。92例患者中最常见的单一异常分别为5q-(29例,31.5%)、-7(22例,23.9%)、1q三体(14例,15.2%)和+8(13例,14.1%)。我们详细介绍了细胞遗传学研究结果,并结合患者年龄、形态学分类、临床病程和预后影响进行了讨论。证明了细胞遗传学研究结果对MDS多步骤发病机制的阐述,特别强调了核型不稳定性。