CD34 and p53 Immunohistochemical Stains Differentiate Hypocellular Myelodysplastic Syndrome (hMDS) from Aplastic Anemia and a CD34 Immunohistochemical Stain Provides Useful Survival Information for hMDS.
10.3343/alm.2014.34.6.426
- Author:
Choong Hwan CHA
1
;
Chan Jeoung PARK
;
Hyun Sook CHI
;
Eul Ju SEO
;
Seongsoo JANG
;
Young Uk CHO
;
Kyoo Hyung LEE
;
Je Hwan LEE
;
Jung Hee LEE
;
Ho Joon IM
;
Jong Jin SEO
Author Information
1. Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. cjpark@amc.seoul.kr, cchoongh@gnah.co.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Hypocellular myelodysplastic syndrome;
Aplastic anemia;
Immunohistochemistry;
CD34;
p53
- MeSH:
Adolescent;
Adult;
Anemia, Aplastic/*diagnosis;
Antigens, CD34/*metabolism;
Bone Marrow/metabolism/*pathology;
Child;
Chromosome Aberrations;
Diagnosis, Differential;
Female;
Humans;
Immunohistochemistry;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Myelodysplastic Syndromes/*diagnosis/mortality;
ROC Curve;
Tumor Suppressor Protein p53/*metabolism
- From:Annals of Laboratory Medicine
2014;34(6):426-432
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The presence of significant dysplasia in bone marrow (BM) aspirates helps to distinguish between hypocellular myelodysplastic syndrome (hMDS) and aplastic anemia (AA). Occasionally, diluted BM aspirates make it difficult to recognize dysplastic changes and can also negatively affect the detection of cytogenetic abnormalities in hMDS. We evaluated the usefulness of CD34 and p53 immunoreactivity for discriminating between hMDS and AA and for estimating survival outcomes in hMDS patients. METHODS: BM clot section (BMC) or BM biopsy (BMB) specimens were obtained from 64 hMDS/AA patients (33 with hMDS and 31 with AA) and seven controls. Immunohistochemical (IHC) staining for CD34 and p53 was performed by using the EnVision detection system (Dako, Denmark). We compared the results of IHC staining, BM findings, and chromosomal analyses, and determined overall survival outcomes. RESULTS: The number of CD34- and p53-positive BM cells was higher among the patients with hMDS than among the patients with AA (P<0.001 and P=0.001, respectively). hMDS patients with increased CD34-positive cells had significantly poorer survival outcomes compared with those with normal number of CD34-positive cells (P=0.013). CONCLUSIONS: CD34 and p53 IHC stains of BMC or BMB provide useful information for differentiating between hMDS and AA. CD34 IHC staining of BMC or BMB also provides useful information for estimating survival outcomes in hMDS patients.