Assessment of Prognostic Factors in 102 Patients with Myelodysplastic Syndrome-Osteoblasts are Related to Survival

In a group of 102 patients with myelodysplastic syndrome an evaluation of bone marrow biopsy was performed in order to assess prognostic impact on survival. The following characteristics were included in the analysis: cellularity, erythropoiesis, granulopoiesis, thrombopoiesis, lymphatic nodules, mastocytes, dyserythropoiesis, dysgranulopoiesis, dysthrombopoiesis, blasts, atypical localisation of immature precursor cells, fibrosis, osteoblasts and osteoclasts on bone surfaces. Data were statistically analysed by stepwise Cox proportional hazards regression. Survival was compared between FAB sub-classes, with better prognosis for RA and RARS patients and poor for CMML patients. Better survival was found in patients without dysgranulopoiesis and in those with osteoblasts on bone surfaces. Agreement with established prognostic factors indicates a representative sample. Relationship of osteoblasts to better survival shows involvement of bone tissue in MDS, suggesting it might be useful to include assessment of bone tissue features in histopathologic evaluation.