Abnormalities of CD34+ cells differentiation and bone marrow cell cycle in myelodysplastic syndrome / 中华内科杂志

ABSTRACT

Objectives To detect the abnormalities of CD34+ cells differentiation and bone marrow cell cycle in myelodysplastic syndrome (MDS). Methods Fifty newly diagnosed MDS ( 17 in low risk and 33 in high risk), 8 acute myeloid leukemia preceded by MDS (MDS-AML) and 25 normal controls were enrolled into this study. Their CD34+ CD38+, CD34+CD38- bone marrow cells and bone marrow cell cycle were measured with flow cytometry. Results The mean percentages of CD34+ cells in bone marrow karyocyte of high risk [ (2.29 ±2.17)% ] and MDS-AML groups [ ( 18.69 ± 17.47)% ] were significantly higher than that of control group [ ( 0.36 ± 0.49 )%, P ＜ 0.05 ]. The mean percentages of CD34+CD38+ cells were significantly lower in low risk, high risk and MDS-AML groups [ ( 86.09 ± 7.79 )%, ( 81.68 ± 11.82)% and (82.88 ±2.60)%, respectively] than that in control group [ (92.21 ±3.85)%, P＜0.05], thus the percentages of CD34+CD38- cells were significantly higher in either MDS (low risk and high risk) or MDS-AML groups [ (13.91 ±7.79)%, (18.32 ±11.82)% or (17.13 ±2.60)%, respectively] than that in control group [ (7.79 ± 3.85 )%, P ＜ 0.05 ]. The percentages of CD+34 CD-38 cells of MDS cases correlated directly with their International Prognostic Scoring System (IPSS) (r =0.493, P =0.001 ) and WHO Adapted Prognostic Scoring System (WPSS) ( r = 0.586, P = 0.000 ) scores. The percentages of bone marrow mononuclea cells (BMMNCs) in G0/G1 phase of in low risk, high risk and MDS-AML groups [ (94.52 ±4.32)%, (96.07 ± 3.88 )% and (94.65 ± 4.55 )%, respectively ] were significantly higher than that in control group[ (88.94 ±7.30)%, P ＜0.01 ], thus the percentages of BMMNCs in S and G2/M phase were significantly lower in either MDS (low risk and high risk) or MDS-AML groups than that in control group (P＜0.05). MDS patients with low percentages of CD34+CD38- cells presented higher therapeutic efficacy than those with high percentages of CD34+CD38- cells, while without significant differences ( P ＞ 0.05 ) .Conclusions There are abnormalities of differentiation of CD34+ bone marrow cells and high proportion of G0/G1 cells which indicates a G1 phase arrest in MDS that might be involved in the pathogenesis of MDS. So the examination of CD34+ bone marrow cells and cell cycle might be helpful for MDS diagnosis and assessment of prognosis and therapeutic effects.