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Myelodysplasia in Ugandan patients with HIV/AIDS: an autopsy study
Background:
Myelodysplasia has been reported to occur quite frequently in the spectrum of HIV/AIDS disease and is thought to be partly responsible for bone marrow failure in these patients. However, the frequency and type of myelodysplasia appear to differ at different stages of the disease in different populations with mechanisms of its development not well understood.
Objective:
To document the pattern of myelodysplasia in Ugandan patients with terminal HIV/AIDS disease.
Design:
Prospective descriptive study.
Setting:
Department of Pathology, Faculty of Medicine, Makerere University College of Health Sciences
Subjects:
Bone marrow necropsies from patients who died with AIDS disease at Mulago teaching hospital in Kampala, Uganda during a one-year period.
Results:
Eighty-four (84%) of the 50 cases studied had myelodysplasia with 39 cases having megakaryocytic myelodysplasia. Myelodysplasia involving erythroid cell series occurred in 23 and in 20 of these cases was in combination with megakaryocytic dysplasia. Granulocyte myelodysplastic features were observed in only two cases and these two cases did not have other cell lines involved.
Conclusion:
Myelodysplastic features are common in HIV patients with megakaryocytic and eythroid cell lines being the most affected. This could be due to the direct HIV effect, or the combined effect of opportunistic infections, neoplasms, drugs and HIV itself affecting the haemopoietic stem cell and or its microenvironment.
