Chromosomal Structural Changes In Patients With Myelodysplastic Symdromes

【Objective】To study the clinical and laboratory features of myelodysplastic syndromes(MDS) patients with chromosomal structural changes.【Methods】Among 584 MDS cases with cytogenetic data,patients with chromosomal structural changes were reclassified according to the WHO criteria,and their clinical and laboratory features were analyzed retrospectively.【Result】1.The incidence of chromosomal structural changes in patients with MDS was 7.4%,and i(17)(q10),t(1;3)(p36;q21),der(1;7)(q10;p10) and der(22) occured frequently.The chromosomal structural changes in 13 cases were the first report in the literatures.2.i(17)(q10).was a sole abnormality.Patients with i(17)(q10) was characterized by moderate to severe anemia and a poor prognosis. Predominant dysgranulocytopoiesis and dysmegakaryocytopoiesis, including a nuclear shift to the left,pseudo Pelger-H(u|¨)et anomaly, hypogranularity and increased micromegakaryocytes were observed in all cases with i(17)(q10).3.Patients with t(1;3)(p36;q21) revealed macrocytic anemia and obvious dysmegakaryocytopoiesis and dysgranulocytopoiesis, accompany with defective diffenrentiation and monocytosis.The bone marrow cells from MDS patients with t(1;3)(p36;q21) mainly or only expressed MEL1s.4.The initial symptom of patients with der(1;7)(q10;p10) was infections. These patients showed macrocytic or normocytic anemia.Trilinege dysplasia was found in the bone marrow smears.The patients had short median survival.5.Patients with der(22) revealed anemia,normal or elevated platelet counts.Hypogranularity and pseudo Pelger-H(u|¨)et anomaly were present in all cases with der(22).Megakaryocytes were small and generally contained one or two.nuclei.A translocation involvement of 22q11 was frequently found in the patients with der(22).【Conclusions】MDS patients,with i(17)(q10),t(1;3)(p36;q21) and der(1;7)(q10;p10) may be new unique clinical-pathologic subsets.Whether MDS patients with der(22) considered as a new unique subject remains to be confirmed by future studies.