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Published on: November 3, 2018
High-level CD34 expression on megakaryocytes independently predicts an adverse outcome in patients with
Guilin Tang1, Sa A Wang, Madhu Menon
1Department of Pathology, University of Massachusetts Medical Center, Worcester, MA 01605, USA.
Abstract:
Expression of CD34 on mature-appearing megakaryocytes can be seen in various intrinsic bone marrow (BM) disorders as well as reactive bone marrows. In this study we investigate the clinical significance of CD34+ megakaryocytes in myelodysplastic syndromes (MDSs). Expression of CD34 on megakaryocytes was assessed on BM biopsies obtained from 202 patients with MDS. High-level (≥20%) CD34 expression on megakaryocytes was found in BM of 29 patients (14%). The expression of CD34 on megakaryocytes is correlated with severe cytopenia, higher numbers of myeloblasts, more frequent and higher risk cytogenetic abnormalities, and a shorter overall survival. Multivariate analysis indicated that the expression of CD34 on megakaryocytes could be a strong and an independent poor prognostic factor in MDS, with a hazard ratio of 2.53.
Insights
CD34 expression on megakaryocytes indicates a poor prognosis in myelodysplastic syndromes (MDS). This finding helps identify patients with severe cytopenia and higher risk of adverse outcomes, guiding treatment strategies.
Area of Science:
- Hematology
- Oncology
- Bone Marrow Disorders
Background:
- CD34 expression on megakaryocytes is observed in various bone marrow disorders.
- The clinical significance of CD34+ megakaryocytes in myelodysplastic syndromes (MDS) requires further investigation.
Purpose of the Study:
- To investigate the clinical significance of CD34+ megakaryocytes in patients with myelodysplastic syndromes (MDS).
- To determine if CD34 expression on megakaryocytes is a prognostic factor in MDS.
Main Methods:
- Bone marrow (BM) biopsies from 202 patients with MDS were analyzed for CD34 expression on megakaryocytes.
- High-level CD34 expression was defined as ≥20% on megakaryocytes.
Main Results:
- High-level CD34 expression on megakaryocytes was identified in 14% of MDS patients.
- CD34+ megakaryocytes correlated with severe cytopenia, increased myeloblasts, and higher-risk cytogenetic abnormalities.
- This expression was associated with shorter overall survival.
Conclusions:
- CD34 expression on megakaryocytes is a significant indicator of poor prognosis in MDS.
- Multivariate analysis confirmed CD34+ megakaryocytes as an independent poor prognostic factor in MDS (Hazard Ratio = 2.53).
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