Immunohematological findings in myelodysplastic syndrome

Background: Few immunohematological studies have been done in myelodysplast ic syndrome (MDS). Methods: Twenty-nine MDS patients were retrospectively e valuated with a direct antiglobulin test (DAT), antibody screening, serum e lectrophoresis and immunoelectrophoresis. Clinical and laboratory studies ( hemoglobin level, reticulocyte count, DHL, total and indirect bilirubin) we re done simultaneously, as well as the French-American-British subtype and bone marrow biopsy findings. Results: Alloantibodies were demonstrated in 1 7 patients (58.6%), autoantibodies in 10(34.4%) patients and cold agglutini n in 18 (62%) patients. DAT was mediated by only IgG in 8 patients (80%), b y IgG and C3 in 1 patient (10%) and by IgG, IgA and C3 in 1 (10%) patient. No hemolytic disease occurred in patients with autoantibodies. Increased se rum gammaglobulin was observed in 16 (54.4%) patients. There was no correla tion between the incidence of allo-/autoantibodies and the gammaglobulin le vel (p = 0.937) and the presence of lymphocyte infiltrates in bone marrow b iopsies (p = 0.156). No significant difference was observed when the incide nce of autoantibodies and number of red blood cell transfusions were compar ed (p = 0.334). Patients with refractory anemia and refractory anemia with ringed sideroblasts subtypes had a higher incidence of allo-/autoantibodies than other MDS subtypes(p = 0.03). Conclusion: Patients with MDS, in parti cular refractory anemia and refractory anemia with ringed sideroblasts have a high incidence of allo- and autoantibodies, probably related to intrinsi c immune disorder, without clinical or laboratory hemolysis. Copyright (C) 2001 S. Karger AG, Basel.