Angiogenesis and Survival in Patients with Myelodysplastic Syndrome

Abstract

Angiogenesis has been implicated in the pathogenesis and prognosis of myelodysplastic syndrome (MDS). In this study, we investigated the relationship between microvessel density (MVD), vascular endothelial growth factor (VEGF) expression, common morphological and clinical factors, and survival in patients with MDS. We examined the MVD of paraffin-embedded bone marrow sections from 70 MDS patients and 31 controls. VEGF expression was determined in 50 patients and 20 controls. The median MVD in MDS patients was significantly higher than that in controls (p = 0.025), whereas there was no difference in VEGF expression between MDS patients and controls. In univariate analysis, increased MVD was associated with a shorter survival time (p = 0.023). However, in multivariate analysis, MVD was not an independent predictor of survival. The VEGF expression did not influence survival in univariate analysis. Survival was independently influenced by platelet count (p = 0.0073), cytogenetic risk category (p = 0.022), and transfusion dependence (p = 0.0073). Neither MVD nor VEGF expression were predictors for progression to acute myeloid leukemia in univariate analysis. Progression to acute myeloid leukemia was independently influenced only by the cytogenetic risk category (p = 0.022). This study confirmed increased MVD in MDS. It does not support an independent prognostic role of angiogenesis in MDS.

The microenvironment in human myeloid malignancies: emerging concepts and therapeutic implications

“…As such, increased microvessel density is predictive of a poor outcome in most myeloid malignancies. [100][101][102][103][104][105] The activation of a leukemia-associated neoangiogenic program is instructed by proangiogenic factors released by the neoplastic cells, including VEGF, HGF, bFGF, and TNFa. [106][107][108][109] Cytokine contribution to angiogenesis in non-BCR-ABL MPN has recently been reviewed elsewhere.…”

Histopathology in the diagnosis of high-risk myelodysplastic syndromes

“…In addition, immunostaining of CD34 is useful for assessing the microvessel density of the bone marrow and is expected to be applied to prognostic predictions. [15][16][17] However, it should be noted that CD34 is occasionally positive in megakaryocytes and erythroblasts. Markers applicable for detecting the myeloid-monocytic lineage comprise myeloperoxidase (MPO), CD68, and CD117 (c-Kit).…”

Myelodysplastische Syndrome

“…Dabei ist am ehesten Transforming Growth Factor Beta1 (TGFß1) einer der für die veränderte Genexpression verantwortlichen "extrin sischen Triggerfaktoren". Auch eine vermehrte Gefäß neubildung (Neoangiogenese) im Knochenmark kann mit der Entwicklung eines MDS vergesellschaftet sein [9].…”