Journal of Clinical Oncology, Vol 1, 627-634, Copyright © 1983 by American Society of Clinical Oncology
Marrow cytogenetic and cell-culture analyses of the myelodysplastic syndromes: insights to pathophysiology and prognosis
EJ Gold, M Conjalka, LM Pelus, SC Jhanwar, H Broxmeyer, AB Middleton, BD Clarkson and MA Moore
Marrow cytogenetic and granulocyte-macrophage colony formation (CFU-GM)
studies were performed on 34 previously untreated patients with documented
myelodysplastic syndromes seen between January 1978 and June 1982. All
patients were managed without chemotherapy until progression to acute
leukemia was observed. All 10 patients with exclusively abnormal marrow
metaphases developed acute leukemia (100%) while only one (7%) of 14
patients with solely normal marrow metaphases subsequently developed
leukemia (p less than 0.001). Three (42%) of the seven patients with both
normal and abnormal marrow metaphases developed acute leukemia. Fifteen
(86%) of the 19 patients with either large cluster or no growth patterns
developed acute leukemia while only two (13%) of 15 patients with either
small cluster or colony forming growth patterns developed acute leukemia (p
less than 0.001). Abnormal marrow cytogenetic status correlated with
abnormal marrow CFU-GM growth pattern (p less than 0.05). Analysis of
CFU-GM sensitivity to inhibition by prostaglandin E was performed in 12
patients. Nine patients showed CFU-GM refractoriness to inhibition by
prostaglandin E. Seven of these patients eventually developed leukemia.
Three patients had CFU-GMs which were initially sensitive to prostaglandin
E inhibition. In these three patients, a loss of CFU-GM sensitivity to
prostaglandin E was observed prior to their progression to morphologically
identifiable acute leukemia.
