THERAPY-RELATED MYELODYSPLASTIC SYNDROMES - FAB CLASSIFICATION, BONE-MARROW HISTOLOGY, AND IMMUNOHISTOLOGY IN THE PROGNOSTIC ASSESSMENT

In this study we describe the morphologic and immunohistochemical eval uation of bone marrow biopsies from 14 patients with therapy-related m yelodysplastic syndromes (t-MDS). We employed CD34, anti-HLA-Dr, anti- elastase, CD68, anti-glycophorin, CD61 monoclonal antibodies immunosta ining, and enzyme histochemistry for chloroacetate esterase. Moreover, we used PC10, a MAb raised against the proliferating cell nuclear ant igen, to study the proliferative capacity of these marrows. Our data s uggest that diagnosis of refractory anemia with excess of blasts (vers us chronic myelomonocytic leukemia), the abnormal localization of imma ture precursors, marrow fibrosis, and augmented CD34 expression in the bone marrow biopsy are ominous prognostic factors at a statistically significant level (p < 0.0005). A combined morpho-immunohistochemical analysis of bone marrow biopsy correctly classifies t-MDS cases accord ing to the biologic and clinical aggressiveness.