HEMOGLOBIN-F IN MYELODYSPLASTIC SYNDROME

Reactivation of fetal hemoglobin synthesis in adulthood can be seen in hematological disorders affecting the erythropoietic system. The obje ctive of the present study was to evaluate the incidence and prognosti c significance of increased hemoglobin F in patients with myelodysplas tic syndrome. Hemoglobin F concentrations and G gamma/G gamma+A gamma- globin chain ratios were determined in 26 patients with primary myelod ysplastic syndrome. Median age of the patients was 65 years; all FAB s ubtypes were included. Increased hemoglobin F concentration of up to 2 0% of total hemoglobin (normal: below 2%) was seen in 16 patients; ten patients had normal values. There was a significant relation between hemoglobin F concentration and the course of disease, e.g., 12 of the 16 patients with elevated hemoglobin F survived at least 1 year after the examination, in contrast to only three of the ten patients with no rmal hemoglobin F (p < 0.025). All of six patients with hemoglobin F a bove 5% survived at least 1 year. There was no significant difference in the hemoglobin F concentration between patients with and without cy togenetic anomalies. The G gamma/G gamma+A gamma-globin chain ratio wa s slightly elevated in all patients, with a weak correlation to the de gree of hemoglobin F elevation. The values were not of additional prog nostic significance. The data of the present study suggest that the he moglobin F concentration may be a prognostic parameter in myelodysplas tic syndrome; increased hemoglobin F concentration may indicate a bett er prognosis.