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Query: UMLS:C0026986 (
myelodysplastic syndrome
)
14,926
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The
5q- syndrome
is a
myelodysplastic syndrome
with the 5q deletion as the sole karyotypic abnormality. The human ATX1 homologue (HAH1), encodes a copper-binding protein with a role in antioxidant defence. We have mapped this gene to the 3 Mb critical region of gene loss of the
5q- syndrome
within 5q32, flanked by the genes for ADRB2 and IL12B, using gene dosage analysis. Fine physical mapping of the HAH1 gene within this genomic interval was then performed by screening YAC and BAC contigs spanning the critical region of the
5q- syndrome
using PCR amplification. The HAH1 gene maps immediately adjacent to the SPARC gene at 5q32, and is flanked by the genetic markers D5S1838 and D5S1419. The HAH1 gene is expressed in haematological tissues and plays a role in antioxidant defence. Antioxidant levels are low in most cancers and the importance of antioxidant enzymes in cancer genesis is well recognised. Genomic localisation, function and expression would suggest that the HAH1 gene represents a candidate gene for the
5q-syndrome
.
...
PMID:Physical mapping of the human ATX1 homologue (HAH1) to the critical region of the 5q- syndrome within 5q32, and immediately adjacent to the SPARC gene. 1098 93
The
5q- syndrome
is a distinct subtype of
myelodysplastic syndrome
(
MDS
) characterized by refractory anemia, deletion of the long arm of chromosome 5, del(5q), as the sole cytogenetic abnormality, and a low frequency of transformation to acute leukemia. Using combined immunophenotyping and fluorescence in situ hybridization (FISH), studies were carried out on bone marrow smears of three
5q- syndrome
cases to identify the cell lineages carrying the 5q deletion. In all three cases, the granulocytic, monocytic, and erythroid lineages possessed the del(5q) clonal marker, whereas the T-lymphocytes did not. Interestingly, in one case, cells of B-lymphoid lineage also showed the presence of the del(5q). This is the first report to date showing involvement of an acquired 5q deletion associated with
MDS
in B-cells. This result suggests that in some cases,
MDS
arises in a multipotent cell with a capacity to differentiate into both myeloid and lymphoid cells.
...
PMID:Combined immunophenotyping and FISH identifies the involvement of B-cells in 5q- syndrome. 1099 2
The objectives of this study were to expand on recent observations that have suggested decreased thrombopoietin receptor (c-Mpl) expression in megakaryocytes of patients with polycythemia vera (PV) and agnogenic myeloid metaplasia (AMM). We applied an immunoperoxidase method with anti-c-Mpl antibody to 55 bone marrow sections from previously untreated patients with chronic myeloproliferative disorder (CMPD) or
myelodysplastic syndrome
(
MDS
). These included 8 patients with PV, 15 with AMM, 9 with essential thrombocythemia, 5 with chronic myelocytic leukemia, 9 with the
5q-syndrome
and 9 with
MDS
with fibrosis. The findings were compared with those in four patients with reactive erythrocytosis (RE), six with immune thrombocytopenic purpura (ITP) and five normal controls. Staining intensity (SI) was moderate to strong both in normal controls and in patients with RE or ITP. In contrast, SI was weak in variable proportions of the megakaryocytes in every one of the aforementioned clonal myeloid disorders. The staining pattern (SP) was relatively uniform in
MDS
and heterogeneous in CMPD. Neither SI nor SP was significantly correlated with certain clinical or laboratory parameters. We concluded that altered megakaryocyte c-Mpl expression may be a nonspecific phenomenon in various subtypes of both CMPD and
MDS
. However, the characteristic staining patterns may complement the morphological distinction between clonal and reactive myeloproliferation.
...
PMID:Megakaryocyte c-Mpl expression in chronic myeloproliferative disorders and the myelodysplastic syndrome: immunoperoxidase staining patterns and clinical correlates. 1100 52
One of the most common structural rearrangements in
myelodysplastic syndrome
(
MDS
) is a deletion of the long arm of chromosome 5, del(5q). The
5q- syndrome
is a distinct entity, that presents with specific morphologic abnormalities of the megakaryocytic lineage. Thus, we evaluated the presence or absence of the del(5q) in these cells. We performed fluorescence in situ hybridization analysis using unique sequence probes (one for 5q31, the other for the 5p telomeric band), and tested bone marrow specimens from 10 patients with
MDS
(including 6 patients with the
5q- syndrome
) and a del(5q). Megakaryocytes were identified by nuclear morphology, size, and ploidy index. Our results demonstrate the presence of the del(5q) in the megakaryocytic lineage and, thus, the involvement of these cells in the disease process.
...
PMID:Deletion of 5q31 is observed in megakaryocytic cells in patients with myelodysplastic syndromes and a del(5q), including the 5q- syndrome. 1106 80
Cellular and extracellular alterations of various fibrogenic cytokines have been described in a number of different chronic myeloid disorders that are associated with myelofibrosis. However, the available information related to both
myelodysplastic syndrome
with myelofibrosis (MDS-f) and bone marrow histochemical analysis is limited. In the current study, bone marrow immunohistochemical staining for platelet-derived growth factor, transforming growth factor (TGF)-beta, basic fibroblast growth factor (bFGF), and their receptors was performed in 9 patients with
MDS
-f, 9 patients with essential thrombocythemia (ET), 8 patients with
5q- syndrome
, and 5 healthy control subjects. In addition, TGF-beta1 messenger RNA (mRNA) analysis was performed in 5 patients, each with
MDS
-f, myelofibrosis with myeloid metaplasia (MMM), polycythemia vera (PV), ET, and immune thrombocytopenic purpura, and in healthy control subjects. In general, protein and transcript expression patterns were similar to normal patterns and not significantly different among the various disease groups. The only exception was a reduced concentration of bFGF-expressing stromal cells in patients with PV, ET, and MMM.
...
PMID:Bone marrow histochemical studies of fibrogenic cytokines and their receptors in myelodysplastic syndrome with myelofibrosis and related disorders. 1118 90
The prognostic impact of karyotypic patterns in a consecutive series of 389 adult
myelodysplastic syndromes
(
MDS
) was investigated. Time period did not significantly influence the survival times. In the analyses, the
MDS
cases were subdivided into the cytogenetic subgroups used in the International Prognostic Scoring System, i.e. favourable [-Y, del(5q) or del(20q) as single aberrations or normal karyotype, n = 241], poor [-7, del(7q), der(1;7) or complex karyotypes, i.e. > or = three abnormalities, n = 89] and intermediate (other aberrations, n = 59). The survival times correlated well with the prognostic subgroups, confirming that the cytogenetic classification was valid. Expressed as hazard ratios (HRs), with the favourable subgroup as the reference, the intermediate and poor subgroup HRs increased to 1.5 (95% confidence interval, 1.1-2.1) and 3.2 (2.4-4.1) respectively. Sex, age, morphological subtype and smoking habits significantly modified this prognostic impact. Shorter survival was detected for men in the favourable and the intermediate subgroups, but not in the poor prognosis subgroup. Using women in the favourable subgroup as the reference and adjusting for age, the HR for men was 1.6 (1.2-2.1) in the favourable subgroup. Adjusting for smoking habits as well decreased the HR to 1.4 (1.1-2.0) and, when also excluding cases with del(5q) as the sole anomaly, no significant difference could be discerned [HR 1.2 (0.9-1.6], suggesting that the better outcome for women in the favourable subgroup was mainly as a result of the '
5q-syndrome
' and to smoking habits. In the intermediate subgroup, the corresponding HRs were 3.0 (1.5-6.0) when adjusted for age and 2.7 (1.3-5.5) when also adjusted for smoking habits. Different survival times between men and women have never previously been reported for this
MDS
group. Although it remains to be elucidated whether environmental and/or constitutional factors cause the observed sex-related difference, these observations have obvious clinical ramifications, not least in designing and evaluating therapy protocols.
...
PMID:The prognostic impact of karyotypic subgroups in myelodysplastic syndromes is strongly modified by sex. 1138 Mar 98
Transfusion of RBC units, the only current treatment for many
myelodysplastic syndromes
, and excess intestinal absorption of Fe related to dyserythopoiesis often result in iron overload. This condition is associated with high rates of morbidity and mortality. High-risk patients include those with refractory anemia, sideroblastic anemia,
5q-syndrome
, patients with a good prognosis (low or lower intermediate international prognosis score), patients having received over 100 RBC units, and patients under the age of 70. Deferoxamine, while it can prevent iron overload, is a strenuous treatment requiring 8-to-12 hour-overnight subcutaneous injections. When patients comply with the regimen, it efficiently prevents mortality due to iron overload, but must be implemented early in the disorder, usually before transfusing 20 RBC concentrates. A simple way of monitoring iron overload is to measure seric ferritin levels and record the number of RBC concentrates. The chelating treatment should be modulated according to age,
MDS
type, international prognosis score, number of RBC units received, ferritin levels, and most of all, patient tolerance. The direct subcutaneous approach is currently being evaluated by the French Group for Myelodysplasias for its efficiency to prevent disorders, but seems to be both efficient and well complied with (a national protocol is under way). The recent findings on the proteins implied in iron recycling by macrophages after destruction of RBCs, may in the long term, enable us to manage patients with less burdensome treatments and more effective new oral chelates.
...
PMID:[Iron overload and myelodysplastic syndromes]. 1172 96
The
5q- syndrome
is the most distinct of the
myelodysplastic syndromes
, and the molecular basis for this disorder remains unknown. We describe the narrowing of the common deleted region (CDR) of the
5q- syndrome
to the approximately 1.5-megabases interval at 5q32 flanked by D5S413 and the GLRA1 gene. The Ensembl gene prediction program has been used for the complete genomic annotation of the CDR. The CDR is gene rich and contains 24 known genes and 16 novel (predicted) genes. Of 40 genes in the CDR, 33 are expressed in CD34(+) cells and, therefore, represent candidate genes since they are expressed within the hematopoietic stem/progenitor cell compartment. A number of the genes assigned to the CDR represent good candidates for the
5q- syndrome
, including MEGF1, G3BP, and several of the novel gene predictions. These data now afford a comprehensive mutational/expression analysis of all candidate genes assigned to the CDR.
...
PMID:Narrowing and genomic annotation of the commonly deleted region of the 5q- syndrome. 1203 1
The
5q-syndrome
has been recognized as a distinct subtype of
myelodysplastic syndrome
(
MDS
) with characteristic clinical and pathologic features. Nevertheless, the definition of this syndrome is imprecise. To better understand how the
5q-syndrome
is related to other "5q- only" myeloid disorders, we searched our conventional cytogenetics file for cases with 5q- as the sole karyotypic abnormality. 31 cases of "5q- only" myeloid disorders were found, and they were refractory anemia (n = 16), refractory anemia with excess blasts (RAEB) (n = 5), RAEB in transformation (n = 1), chronic myelomonocytic leukemia (n = 1) and acute myeloid leukemia (n = 8). They included 15 men and 16 women, with a median age of 67 years (range, 40-84 years). The marrow blast count was < or = 11% in 22 cases and > or = 25% in the remaining nine cases. The following morphologic features were common in the marrow: megakaryocytic hypolobation (30/31, 97%), erythroid hypoplasia (26/31, 84%), basophilia (19/31, 62%) and eosinophilia (16/31, 52%). Of those with < or = 11% blasts, 7/22 cases met the criteria of the
5q-syndrome
, as defined by high mean corpuscle volume (MCV), normal/high platelet counts, and megakaryocytic hypolobation. Except for the two defining parameters for the
5q-syndrome
(MCV and platelet count), there was no significant difference in hematologic parameters between the
5q-syndrome
and other cases with < or = 11% blasts. Furthermore, no significant difference in the chromosomal breakpoints or survival was found between these two groups. We conclude that "5q- only"
MDS
show consistent morphologic features, suggesting a common pathogenesis related to their similar cytogenetic abnormality. In "5q- only"
MDS
with < or = 11% marrow blasts, strict application of the conventional criteria of the
5q-syndrome
may not be necessary in predicting the overall prognosis.
...
PMID:Myeloid disorders with deletion of 5q as the sole karyotypic abnormality: the clinical and pathologic spectrum. 1215 62
The WHO classification of hematological malignancies includes
5q-syndrome
as a separate category within
myelodysplastic syndromes
(
MDS
). Clinically, patients with
5q-syndrome
have a milder disease than patients with other
MDS
. The basis for this difference is not known. Identifying
5q-syndrome
can be difficult because some of its morphologic and cytogenetic features are similar to those of other
MDS
. We compared apoptosis between
5q-syndrome
and other refractory anemias. We found lower levels of apoptosis in
5q-syndrome
as detected by less disruption of mitochondrial potential (P=0.008) and decreased annexin V positivity (P=0.01). Our results suggest that lower apoptosis in
5q-syndrome
may explain the milder clinical course of the disease and distinguish
5q-syndrome
from other
MDS
.
...
PMID:Less apoptosis in patients with 5q-syndrome than in patients with refractory anemia. 1216 50
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