Analysis Of 86 Patients With Myelodysplastic Syndromes

Objective Collected Myelodysplastic syndrome(Myelodysplastic syndromes,or MDS) cases of clinical data, analysis of MDS patients clinical characteristics of the first hospital of LANZHOU university, to discuss the relevance between MDS and AL(actue leukemia), MDS and PNH(Paroxysmal nocturnal hemoglobinuria) and MDS and diabetes(DM).Combined with the literature to explore the pathogenesis of MDS,to outlook the development direction of the MDS diagnosis, the MDS classification and the MDS therapy.Methods Through a retrospective analysis of the clinical data of 86 adult MDS patients who were hospitalized(under a preliminary diagnosis) at the first clinical hospital of Lanzhou University during the last five years, and some of the data are analyzed by the software spss22. Results ①Among the female patients,women of the reproductive age(less than 45 years old) share the largest proportion,which is up to 40.74 %. ②Before receiving relative treatments, Patients suffer seriously and pancytopenia becomes the main clinical manifestation. 58.14% of the patients are diagnosed with macrocytic anemia(MA) and 12.79% with type 2 diabetes mellitus(DM). In classification, RCMD(refractory cytopenia with multilineage dysplasia)is common(46.47%); in treatment, immunosuppressive therapy is the main regime. ③62.5% of the patients are diagnosed with iron overload; there is a reduction of CD59 molecule(membrane inhibitor of reactive lysis) in neutrophile granulocytes of 50% of the patients. ④ patients are with abnormal conditions of T lymphocytes,and 27.91% of them have a reduced immune globulin. ⑤ the common clinical features of the 4 cases turning leukemia are as follow: male patients; WHO classification as RAEB(refractory anemia with excess blast); a combination with autoimmune diseases; complex karyotype; a predominately conversion into acute myelogenous leukemia( AML). ⑥ the rate of chromosomal abnormality is 30.19%,of which +8 is the highest.Conclusion ① the first hospital of LANZHOU universityl, the median onset age of the MDS patients was 53 years, multilineage cytopenia becomes the main clinical manifestation., 62.5% of the patients arediagnosed with iron overload;In classification, RCMD(refractory cytopenia with multilineage dysplasia)is the most common(46.47%),the hypo-MDS rate was23%,and the chromosome abnormality rate was 30.2%, 12.79% of the patients with type 2 diabetes mellitus(DM).in treatment, immunosuppressive therapy is the main regime. ②it is likely that there is no qualitative difference between RAEB and AL,but there is only the differences of the number of the blast cells. ③MDS macrocytic anemia is caused by the missing of the hematopoietic stem cell chromosome or by the mutant genes. ④ low-risk MDS patients are suffered with immune injury, and high-risk MDS with immunosuppression. ⑤MDS can combine with PNH; the surface molecules of CD55 and CD59 miss together.⑥myelodysplastic syndrome, an illness with large heterogeneity, the pathogenesis of which remains unclear. Therefore, the diagnosis, classification and treatment of it are challengable, and it may become a breakthrough of the future development to encode the mutant gene function and to get a better understanding of the hematopoietic microenvironment.