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Evaluation of BM cytomorphology after allo-SCT in patients with MDS

Bone Marrow Transplantation volume 48, pages 465–466 (2013)Cite this article

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Evaluation of disease status in myelodysplastic syndromes (MDS) includes assessment of blast count, dysplasia and cellularity by BM cytomorphology. In stem cell recipients with AML, we described dysplasia to be a frequent but nonspecific feature after allogeneic haematopoietic SCT on day 30 and day 100.1 Yet, we found normal cellularity by cytomorphology on day 30 to be associated with positive prognosis in these patients.1 As dysplasia and aberrant cellularity are hallmarks of MDS, we analysed the distribution and potential prognostic impact of these features by cytomorphology in BM aspirates taken on day 100 post transplant. We evaluated 25 MDS and chronic myelomonocytic leukaemia (CMML) patients (11 female, 14 male, median age 58 years, range 28–73 years) in CR at day 100 after SCT. Patients mainly suffered refractory anaemia with excess blasts-2 (RAEB-2, n=11, 44%). Mostly, they were cytogenetically favourable risk (n=19, 76%), each 3/25 patients (12%) had either an intermediate or an unfavourable karyotype according to the International Prognostic Scoring System.2 SCT was the initial therapy for 19/25 patients (76%). The most common transplantation regimen was of reduced intensity conditioning (following the European Group for Blood and Marrow Transplantation definition, n=21, 84%). Most patients were transplanted from an unrelated donor (n=21, 84%). Immunosuppression was either CYA combined with mycophenolic acid (n=17, 68%) or MTX (n=8, 32%). Acute GVHD was experienced by six patients (24%). Detailed patient, donor and transplantation characteristics are given in Table 1.

Table 1 Patient, donor and transplant characteristics
Full size table

Following May Grunwald Giemsa staining, 200 nucleated cells were evaluated per BM sample. The percentage of dysplastic cells in the different haematopoietic lineages (granulopoiesis, GP; erythropoiesis, EP; megakaryopoiesis, MP) was determined.3 Furthermore, overall cellularity (discriminating increased, normal, and reduced cellularity) and cellularity in the distinct haematopoietic lineages was analysed.4

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References

  1. Christopeit M, Miersch K, Klyuchnikov E, Haferlach T, Binder M, Zabelina T et al. Evaluation of BM cytomorphology after allo-SCT in patients with AML. Bone Marrow Transplant 2012; 47: 1538–1544.

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Acknowledgements

We thank Waltraud Schultz and Gerlinde Finger, University of Hamburg, for expert technical assistance.

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Author notes

  1. M Christopeit

    Present address: Department of Cell Biology, Albert Einstein College of Medicine, Bronx, NY, USA,

  2. N Kröger and U Bacher: These authors contributed equally to this work

Authors and Affiliations

  1. Department of Internal Medicine, Oncology and Haematology, University Hospital Halle (Saale), Halle, Germany

    M Christopeit

  2. Department for Stem Cell Transplantation, University Cancer Center, Hamburg, Germany

    S Ocheni, K Miersch, T Zabelina, E Klyuchnikov, F Ayuk, A R Zander, N Kröger & U Bacher

  3. Department of Hematology and Immunology, University of Nigeria Teaching Hospital, Enugu, Nigeria

    S Ocheni

  4. MLL Munich Leukemia Laboratory, Munich, Germany

    T Haferlach

  5. II. Medical Department, University Cancer Center, Hamburg, Germany

    M Binder, P Schafhausen & C Bokemeyer

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  1. M Christopeit
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  2. S Ocheni
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  3. T Haferlach
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  6. E Klyuchnikov
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  7. M Binder
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  13. U Bacher
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Corresponding author

Correspondence to U Bacher.

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TH declares part ownership of Munich Leukemia Laboratory. The other authors have no conflict of interest to declare.

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Christopeit, M., Ocheni, S., Haferlach, T. et al. Evaluation of BM cytomorphology after allo-SCT in patients with MDS. Bone Marrow Transplant 48, 465–466 (2013). https://doi.org/10.1038/bmt.2012.161

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