Air Pollution, Indoor ; analysis ; prevention & control ; Benzene ; analysis ; Housing ; standards ; Humans

OBJECTIVETo determine the risk factors involved in myelodysplastic syndromes (MDS).

METHODSA 1:2 case-control study was conducted in 20 Shanghai' hospitals over a 3-year period, covering 266 "de novo" MDS cases corresponded to FAB criteria, and 532 age- and gender-matched controls from same hospitals with MDS cases. Subjects were all surveyed using the same standard questionnaire including histories of medications (Chloramphenicol, Sulfonamides, Meprobamate, Phenytoin, Colchicine, Cyclophosphamide, Propylthiouracil, Anti-TB medication, Tolbutamide, Primaquine and Chinese traditional herbs such as Bezoar, Angelica, Arsenic, Thunder cloud vine) at least 5 years prior to the onset of the disease, tumors, exposure to benzene, heavy metal, organic phosphates, pesticides, petrol/diesel, organic solvents, dye and hair dye products, radiation, house decorating, alcohol and smoking.

RESULTSOccupational exposure to benzene increased significantly the risk of MDS (OR: 8.52, 95% CI: 2.30 - 31.10). Living near high voltage power lines (100 m) increased significantly the risk of MDS (OR: 1.60, 95% CI: 1.10 - 2.32). House decorating (one year prior to the onset of the disease) increased significantly the risk of MDS (OR: 2.40, 95% CI: 1.38 - 4.14). Other investigated occupational poisons did not increase significantly the risk of MDS. Hair dye products, alcohol and smoking did not increase significantly the risk of MDS.

CONCLUSIONOccupational exposure to benzene, living near high voltage power lines and house decorating are the risk factors of MDS.

Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; etiology ; Risk Factors

This study was aimed to investigate the characteristics of 11 patients with acute myeloid leukemia (AML) accompanying with karyotype t(6;9). The laboratorial and clinical data were analyzed retrospectively, including immunophenotype analysis and result analysis of real-time quantitative PCR detection. The results showed that a high prevalence of M2 was observed. Among 11 cases, 6 of M2, 2 of M4, 2 of M5 and 1 of MDS-RAEBT were found according to FAB criteria. Ten patients had high counts of peripheral white blood cells. Bone marrow dysplasia was seen in only 2 cases, and basophilia occurred in 4 cases. Six patients carried additional cytogenetic aberrations apart from t(6;9). Immunophenotypic analysis showed that all patients were positive for CD117, CD33, CD13, HLA-DR, CD38 and CD123. No NPM1 mutation was observed in all patients and a high level of WT1 was detected in all patients (7/7), out of 7 patients FLT3-ITD mutation was detected in only 3 patients. Follow-up details were available for 7 patients, one of whom died before chemotherapy, and the remaining 6 patients all had no response to IA or DA regimen. Among the 6 patients, 3 did not response to subsequently chemotherapy and all died from infections in a short period after diagnosis, the other 3 patients achieved a complete remission after alternative chemotherapy, but 2 relapsed in a short time and died. It is concluded that AML with cytogenetic aberration of t(6,9) is a distinct disease with a very poor prognosis. The first line chemotherapy such as IA or DA regimen is not effective to such patients, and the effective treatment needs further study.
Adult ; Chromosomes, Human, Pair 6 ; genetics ; Chromosomes, Human, Pair 9 ; genetics ; Female ; Humans ; Karyotype ; Karyotyping ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Translocation, Genetic ; Young Adult