Animals ; Humans ; Myelodysplastic Syndromes ; diagnosis ; genetics ; therapy

Myelodysplastic syndrome (MDS) represents a heterogeneous group of myeloid malignancies characterized by abnormal differentiation and maturation of myeloid cells, bone marrow failure, and a genetic instability with enhanced risk to transform to acute myeloid leukemia. Many factors influence on the prognosis of MDS. The prognosis of MDS subtypes has been changing with the application of World Health Organization (WHO) classification and different new prognostic scoring system, the technology development of cytogenetics and flow cytometry, and the advent of new drugs. A series of recent literatures are summarized on different prognostic factors of MDS. In this review, the controversy in application of WHO classification, MDS prognosis in relation with prognostic scoring system, cytogenetics, immunophenotype and therapeutics were discussed.
Humans ; Immunophenotyping ; Myelodysplastic Syndromes ; classification ; diagnosis ; genetics ; Prognosis

Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic disorders, which have a wide range of clinical manifestations and eventual outcomes. It is useful to predict its risk for patients prognosis. The International Prognostic Scoring System (IPSS) has been the standard tool used to stratify MDS patients since 1997. Other models have been created to improve upon the IPSS.With the application of next-generation sequencing (NGS), several research groups found mutated genes in the majority of MDS patients. Recently, more and more results prove that these mutations have independent prognostic significance. However, mutational information is complex and there are challenges for its clinical application. Despite these limitations, NGS can refine the prediction of prognosis for MDS patients and will improve the care of them. In this article the curent prognostic markers of MDS, the mdecular biological events as new prognostic markers and their advaintages and drawbacks are summarized.
Biomarkers ; Humans ; Mutation ; Myelodysplastic Syndromes ; diagnosis ; genetics ; Prognosis

Myelodysplastic syndrome (MDS) is clonal disorder of hematopoiesis characterized by inefficient hematopoiesis, peripheral blood cytopenias, aberrant differentiation, and risk of progression to acute myeloid leukemia. Although specific karyotypic abnormalities have been found to link to MDS for decades, more recent findings have demonstrated the importance of mutations within individual genes. The recent molecular abnormalities found in MDS include following gene mutation such as TET2, TP53, RUNX1, ASXL1, IDH1/IDH2, EZH2 and RAS. In this review, the recent advances of prognostic molecular markers of MDS and their biological and clinical significance are summarized.
DNA-Binding Proteins ; genetics ; Humans ; Mutation ; Myelodysplastic Syndromes ; diagnosis ; genetics ; Prognosis ; Proto-Oncogene Proteins ; genetics

OBJECTIVETo identify methylation profiles in myelodysplastic syndrome (MDS) and to provide the biomarkers for the early diagnosis and differential diagnosis of MDS.

METHODSGenes were screened for hypermethylation by genome-wide DNA methylation profiles. Transcription down-regulation was determined with a gene expression microarray. Methylation-specific, real-time, and bisulfite-sequencing PCR cloning and sequencing were performed to validate selected genes in MDS cases and non-malignant hematologic diseases (controls). Diagnostic test, such as sensitivity and specificity, was used to evaluate the value of methylation patterns.

RESULTSA draft of methylation patterns was established and refined to 6 genes after validation in 211 patients and 60 controls. The hypermethylated genes were ABAT (97%), DAPP1 (98%), FADD (89%), LRRFIP1 (96%), PLBD1 (89%), and SMPD3 (85%). A combination of 5 or more than 5 genes showed a specificity of 95% and sensitivity of 91.4% for the diagnosis of MDS. The accuracy of diagnosis was 92.3%.

CONCLUSIONWe demonstrated here that the ABAT, DAPP1, FADD, LRRFIP1, PLBD1 and SMPD3 genes are hypermethylated and downregulated in MDS. The six genes could be the markers of the methylation patterns in MDS, as a noninvasive approach for the diagnosis of MDS.

DNA Methylation ; Down-Regulation ; Gene Expression ; Genome, Human ; Humans ; Myelodysplastic Syndromes ; diagnosis ; genetics

OBJECTIVE: To detect chromosomal abnormalities in myelodysplastic syndrome (MDS) patients by fluorescence in situ hybridization (FISH) and conventional cytogenetic analysis (CCA). METHODS: FISH and CCA were performed in 100 patients who were diagnosed with MDS by conventional detection of bone marrow smear and bone marrow biopsy, and were followed up. RESULTS: Forty-eight (48%) patients showed chromosomal abnormalities. The positive rate of -5/5q-, 20q-, +8, -7/7q-, and -Y was 16%, 15%, 12%, 11%, and 5%, respectively, and that of CCA was 11%. The positive rate of molecular genetics abnormalities detected by FISH was obviously higher than that of CCA (P<0.01) and the combination of FISH and CCA increased the detection rate to 49%. The follow-up showed that the prognosis of patients with normal FISH results was significantly better than the abnormal ones. A correlation between complex karyotypes and poor prognosis was observed. Abnormality of -7/7q- was found closely correlated with the higher risk of acute leukemia and death. CONCLUSION Chromosomal abnormalities have been found in 49 MDS patients. Common chromosomal abnormalities in MDS patients include -5/5q-, 20q-, +8 and -7/7q-. FISH combined with CCA can improve the detection rate of chromosomal aberrations in MDS. FISH is more sensitive than CCA for detection and can be used as an important basis for prognostic assessment for MDS.
Chromosome Aberrations ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Myelodysplastic Syndromes ; diagnosis ; genetics ; Prognosis

OBJECTIVETo optimize pre-coated multiple-probe fluorescence in situ hybridization (FISH) to improve its efficiency in cytogenetic diagnosis of acute leukemia.

METHODSThe original multiple-probe FISH techniques were optimized by adjusting the cell density and adding a process of protease digestion. Cytogenetic anomalies were detected in 141 patients with acute lymphocytic leukemia (ALL) or acute myeloid leukemia/ myelodysplastic syndromes (AML/MDS) using the modified technique, and 35 of the patients were also examined using the original technique. The successful detection rate and positive site detection rate were compared between the modified and original techniques.

RESULTSModification of the pre-coated multiple-probe FISH technique resulted in an significant increase of the successful detection rate (from 85.3% to 100%) and the positive site detection rate (from 5.1% to 8.6%) in ALL patients; in AML/MDS patients, the successful detection rate was significantly improved from 67.4% to 99.8% and the positive site detection rate from 3.5% to 6.0% (P<0.01).

CONCLUSIONThe modified pre-coated multiple-probe FISH technique can significantly increase the diagnostic efficiency of cytogenetic abnormalities in leukemic patients.

Chromosome Aberrations ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Karyotyping ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; Myelodysplastic Syndromes ; diagnosis ; genetics

In recent years, significant progresses have been got in study on pathogenesis, treatment and prognosis of myelodysplastic syndromes (MDS), especially on use of new technology, that has great importance for cytogenetics of MDS. Recently, the progress of cytogenetic detection in MDS is very remarkable. Based on the metaphase cytogenetics (MC) method, prognostic significance of cytogenetics in MDS was clarified gradually. For example, people have known the prognostic significance of 12 p-, 11 q-, +21, t(11(q23)), although these genetic abnormalities are rare in the MDS. In addition, chromosome mutation emerged in the process of MDS may indicate the poor prognosis. On the other hand, with the use of SNP-A and aCGH in the study of genetics, MDS cytogenetic abnormality detection rate has been further improved and can reach to 78%. At the same time, some of MDS patients with the "normal karyotype" detected by MC have new hidden aberrations through the SNP or CGH detection, and these patients have a poorer prognosis. In this review, the advances of study on cytogenetic detection for MDS based on MC and SNP-A or aCGH methods are summarized.
Comparative Genomic Hybridization ; methods ; Cytogenetics ; methods ; Humans ; Karyotype ; Karyotyping ; Myelodysplastic Syndromes ; diagnosis ; genetics ; Polymorphism, Single Nucleotide ; Prognosis

It is hard to discriminate myelodysplastic syndrome(MDS) from many benign hematological diseases. To identify the methylation status of zo-1 gene in MDS, the methylation specific PCR (MS-PCR) and reverse transcription-PCR (RT-PCR) were applied to detect the MDS cell line MUTZ-1, bone marrow of a healthy donor and an aplastic anemia patient. MS-PCR was also employed to detect the bone marrow of 72 patients with benign hematological diseases, 35 MDS-RA patients, and 20 MDS-like patients. The results showed that MDS cell line MUTZ-1 displayed complete methylation of zo-1 promoter without mRNA expression. Inversely, a patient with benign hematological disease and a donor with normal bone marrow showed complete unmethylation of this gene with unaffected mRNA expression. No zo-1 promoter methylation was detected in patients with benign hematological diseases, while aberrant hypermethylation of zo-1 gene promoter were found in 48.6% (18/37) of MDS-RA patients. The positive rate of zo-1 methylation in MDS-RA patients was higher than that in patients with benign hematological diseases (p < 0.05). Seven suspected MDS patients manifested hypermethylation status of zo-1 gene (7/20), 2 were followed up for 1 year and transformed into MDS. It is concluded that relatively high hypermethylation rate of zo-1 promoter is observed in MDS-RA, and no methylation in patients with benign hematological diseases. Therefore, zo-1 gene hypermethylation may be served as a useful epigenetic marker in the differential diagnosis for MDS.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; DNA Methylation ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; diagnosis ; genetics ; Young Adult ; Zonula Occludens-1 Protein ; genetics ; metabolism

This study was purposed to compare and analyze the relationship between the abnormality of chromosome karyotypes and diagnosis, prognosis of MDS and AML patients, as well as to explore the characteristics of chromosome prognostic stratification in MDS and AML patients of different ages. The cytogenetic karyotype analysis was performed in 134 cases of MDS and 123 cases of AML by using bone marrow short-term culture and R-banding technique. The results indicated that the detected rates of chromosome abnormal karyotypes in MDS and AML patients were 41% and 61% respectively. The abnormal karyotype analysis of MDS and AML group showed that the abnormal karyotype in MDS group displayed number abnormality as the dominate (mainly the +8), while the abnormal karyotype in AML group displayed structure abnormality as the dominant [mainly, t(15;17) and t(8;21)]. The detected abnormal karyotype are mainly for the +8 which has ambiguous correlation with FAB subtype; the detection rates of complex karyotype abnormalities, favourable prognosis karyotype as well as poor prognosis karyotype in the MDS group obviously higher than that of AML group. Among patients with MDS transformed into AML, 12 cases had chromosome abnormal karyotype. There were 3 cases of chromosome abnormal karyotype in AML group which were transformed by MDS. The analysis of age stratification between two groups showed that the detected rate of abnormal karyotype was enhanced with the increase of age in MDS group, and detected rate in ≥ 60 years old group was obviously higher than that in patients with ≤ 30 age group.The detected rate of complex karyotype abnormalities in three age groups of MDS did not show statistical difference; the detected rate of abnormal karyotype in AML group decreased with the increase of age, the detected rate in ≤ 30 years old group was obviously higher than that in ≥ 60 age group,while the detection rate of complex karyotype abnormalities showed that the detected rate in patients ≥ 60 years old group was obviously higher than that in patients with ≤ 30 years old group; Analysis of karyotype prognosis revealed that the detected rate of poor prognosis karyotype increased along with the age growth both in MDS and AML groups, and detected rate in ≥ 60 years old group was obviously higher than that in ≤ 30 years old group; while analysis of favourable prognosis karyotype in MDS and AML group showed that the detected rate in ≤ 30 years old group was obviously higher than that in ≥ 60 years old group. It is concluded that the patients with MDS and AML have higher chromosomal abnormalities,which have important reference value for the diagnosis, treatment and prognosis, meanwhile, the analysis of chromosome karyotype provides an important basis for prognostic stratification.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Karyotype ; Karyotyping ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; Male ; Middle Aged ; Myelodysplastic Syndromes ; diagnosis ; genetics ; Prognosis ; Young Adult