Maryalice--
When you say these patterns are characteristic of MDS, does that mean that you
and others have studied numbers of patients without MDS to look for these
abnormalities. E.g. Patients with autoimmune disorders, immunodeficiencies (not
just AIDS), toxic injury... I have seen several cases where patients were
suggested to have MDS by flow studies performed by someone I would consider to
be an expert in the field. In one of these patients the abnormalities
spontaneously disappeared (they were restudied by the same lab a few months
later). In the other case the young woman (I think in her 20's) appeared to have
some sort of ill-defined autoimmune disorder. (This woman was being evaluated
for bone marrow transplant because of her "MDS").
I mention this only to emphasize your point that these findings need to be taken
in context of the morphologic, cytogenetic and clinical findings.
Happy Holidays.
Karen
Karen P. Mann, M.D., Ph.D.
Duke University Medical Center
Durham, NC
_______________________________________________________________________________
Subject: Re: hypocellular MDS
From: stetler@box-s.nih.gov at internet
Date: 12/26/97 12:10 PM
Dear Patti,
There is a great deal of research on going inthis area. I feel that
if you can demonstrate distinct myeloid as well as erythroid abnormalities,
then you have excellent support for a diagnosis of MDS. I know several
distinguished flowers who have identified abnormal patterns they find
characteristic of MDS.We have studies this topic ourselves and found
myeloid and erythroid abnormalities in MDS. Our ability to detect these
abnormalities is hampered by the quality of the specimen received. When we
get 6 mL of bone marrow aspirate we get 3 mL of real bone marrow and 3mL of
blood, if we are lucky. Luckily, the granulocytes are abnormal in MDS too.
However, we get few erythroid precursors with a poor specimen. However,
there are useful abnormal immunophenotypic findings in MDS.
You ask if there is "" marker for MDS. I don't think there is a
single marker for MDS, just as there isn't a single marker for follicular
lymphoma, mantle cell lymphoma, AML or ALL. The idea of identifying any
single immunophenotypic marker for diagnosis of a hematopoietic disorder is
not a viable one. It is identification an abnormal pattern that can lead to
the diagnosis. However, remember the consensus conference recommendations
for flow of leukemias and lymphomas. I think they should apply to MD too.
There needs always to be morphological correlation. If you would like more
information please contact me or attend the clinical flow cytometry meeting
in Charleston in August. There you can learn what is happening in this
field.
Maryalice
>Dear flowers,
>Are there any markers that will differentiate between hypocellular MDS
>(refractory
>anemia) from aplastic anemia?
>Patcharin Tanawattanacharoen, MD
>Hematology Branch
>National Heart Lung and Blood Institute
>National Institutes of Health
>Bld 10 Room 7C112
>9000 Rockville, MD 20892,USA
>tel (301) 402 3477
>fax (301) 496 8396
>e-mail:tanawatp@gwgate.nhlbi.nih.gov
Maryalice Stetler-Stevenson
Director Flow Cytometry Unit
Laboratory of Pathology, NCI, NIH
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From: stetler@box-s.nih.gov (Maryalice Stetler-Stevenson)
Subject: Re: hypocellular MDS
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