Histopathology of Myelodysplastic Syndromes: The FAB Classification (Proposals) Applied to Bone Marrow Biopsy

Abstract

Twenty-eight cases of myelodysplastic syndrome (MDS) were reviewed to evaluate whether the morphologic criteria proposed by the French-American-British (FAB) Cooperative Group for marrow smears could be applied to glycol methacrylate embedded trephine biopsies. Bone marrow biopsies and marrow smears were examined separately and then compared for the following parameters: percentage of blasts, dyserythropoiesis, ring sideroblasts, dysmegakaryopoiesis, dysgranulopoiesis, monocytes, cellularity, fibrosis, and "abnormal localization of immature precursors". The results of the histologic (biopsies) and cytologic (marrow smears) examinations were in good agreement in 24 of 28 cases. The authors' results suggest that the five MDS types proposed by the FAB group can be reliably distinguished on bone marrow biopsy with knowledge of the peripheral blood blast and monocyte counts. When the bone marrow aspiration is inadequate, the biopsy can establish diagnosis and type of MDS and rules out aplasia or tumor infiltration as possible alternative causes of cytopenia.

Overexpression of tumor necrosis factor (TNF)-α and interferon (IFN)-γ by bone marrow cells from patients with myelodysplastic syndromes

“…31,32,35 Among several substances which have inhibitory effects on hematopoiesis, increased production of ferritin and PGE 2 have been found in bone marrow cultured cells from MDS patients. 1,39 In vivo administration of ferritin to mice significantly decreased marrow cellularity and peripheral blood nucleated cell count, 28 although BM in MDS are usually normo-or hypercellular. Therefore, ferritin is not responsible for cytopenias in MDS.…”

“…A diagnosis of MDS was based on FAB criteria. 1 None of the patients had received specific therapeutic Table 2. Complementary (c)DNA was synthesized by using associated virus reverse transcriptase (Takara Biomedicals, Kyoto, Japan).…”

“…[1][2][3] The majority of affected patients die within 1-2 years due to overt leukemic transformation or the complication of cytopenias. The development of cytopenias despite the presence of cellular marrow is thought to be due to ineffective hematopoiesis probably associated with frequent apoptosis of hematopoietic cells.…”

“…In vitro examination revealed that the proliferation, as well as death, of hematopoietic cells is regulated by various proteins with stimulatory and inhibitory activities. 1 Colony-stimulating factors (CSFs) [6][7][8][9] and several cytokines [7][8][9][10][11] are known to have proliferative effects on hematopoietic progenitor cells, while several substances such as tumor necrosis factor (TNF) 7,8,[12][13][14] and interferons (IFNs) 13 were demonstrated to inhibit hematopoietic cell growth. Although the exact function of these substances in vivo has not yet been elucidated, overexpression of certain soluble factors by bone marrow cells may disrupt hematopoiesis by exerting profound inhibitory effects on hematopoietic progenitor cells.…”

Localization of Fas and Fas ligand in bone marrow cells demonstrating myelodysplasia

“…[1][2][3] The majority of affected patients die within 1-2 years due to overt leukemic transformation or the complication of hematocytopenias. The development of hematocytopenias despite the presence of cellular marrow is thought to be due to ineffective hematopoiesis probably associated with frequent apoptosis of hematopoietic cells in the bone marrow.…”