The prognostic value of in vitro cultures of erythroid and megakaryocyte progenitors in myelodysplastic syndromes

The prognostic value of colony formation by granulocyte-macrophage progenit ors (CFU-GM) in myelodysplastic syndromes (MDS) has been investigated in se veral studies. We studied the in vitro growth patterns of hematopoietic pro genitors of 83 patients with an MDS to find out whether erythroid (BFU-E) a nd megakaryocyte (CFU-Meg) cultures yield additional prognostic information to that obtained with CFU-GM cultures. Thirty-nine of 82 patients showed n ormal CFU-GM colony formation; the others had either excessive growth of co lonies/clusters or reduced growth. Five of 74 patients had normal BFU-E and nine of 39 patients normal CFU-Meg growth; the others showed reduced or ab sent colony formation. The cultures of each cell lineage had a similar prog nostic impact: the patients with a normal growth pattern had a lower risk o f developing leukemia and a longer survival than those with an abnormal gro wth pattern (significant difference or trend). All patients with normal BFU -E or CFU-Meg colony growth also had normal CFU-GM colony formation, and al l patients with normal BFU-E growth also had normal CFU-Meg growth. Among t he patients with normal CFU-GM cultures, those with normal erythroid or meg akaryocyte colony formation had a trend towards a better outcome compared t o those with an abnormal growth pattern in the same cell lineage. In conclu sion, erythroid and megakaryocyte cultures did not significantly contribute to the prognostic information obtained with CFU-GM cultures in MDS. (C) 19 99 Elsevier Science Ltd. All rights reserved.