Biologic characteristics of 164 patients with myelodysplastic syndromes

Rates of proliferation, apoptosis and cytokine expression were measured in bone marrow (BM) biopsies of 164 myelodysplastic syndrome (MDS) patients. T here were 107 males and 57 females. Median age was 69 years and 101 had ref ractory, anemia (RA), 17 RA with ringed sideroblasts (RARS), 38 with RA and excess blasts (RAEB) and 8 with RAEB in transformation (RAEB-t). Apoptosis measured by in-situ end labeling (ISEL) was directly related to the number of macrophages (p = 0.028, n = 83). Mean tumor necrosis factor alpha (TNF- alpha) and ISEL positivity were higher in RAEB + RAEB-t patients (p = 0.055 4 and p = 0.06 respectively) while hemoglobin was higher for RA + RARS grou p (p = 0.0472). Patients with high apoptosis had lower white blood cell cou nts (p = 0.0009), lower percentage of blasts (p = 0.0009) and higher number of macrophages (p= 0.0086). We conclude that measurements of apoptosis, pr oliferation and cytokine expression provide important biological informatio n which helps to distinguish RA + RARS patients from RAEB + RAEB-t patients , and may be of additive prognostic significance.