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Pathogenetic implications of internuclear bridging in myelodysplastic syndrome. An Eastern Cooperative Oncology
D R Head1, K Kopecky, J M Bennett
1St. Jude Children's Research Hospital, Memphis, Tennessee.
Abstract:
Numerous morphologic features have been described in bone marrow and peripheral blood in myelodysplastic syndrome (MDS). We draw attention to a high incidence of a subtle morphologic feature, internuclear bridging (INB), not previously recognized as a morphologic feature in MDS. The occurrence of INB in MDS suggests an underlying abnormality of mitotic division that could explain the impaired production of hematopoietic cells, the addition and deletion cytogenetic changes, and the stepwise disease progression and cytogenetic progression characteristic of MDS. Lack of awareness that INB occurs in MDS may cause confusion of MDS and congenital dyserythropoietic anemia type I, a congenital process also characterized by INB.
Insights
Internuclear bridging (INB) is a subtle morphologic feature found in myelodysplastic syndromes (MDS). Its presence suggests abnormal cell division, potentially explaining MDS progression and cytogenetic changes.
Area of Science:
- Hematology
- Cell Biology
- Pathology
Background:
- Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic stem cell disorders.
- Various morphologic abnormalities are recognized in MDS bone marrow and peripheral blood.
- Internuclear bridging (INB) has not been previously identified as a characteristic feature of MDS.
Purpose of the Study:
- To highlight the significance of internuclear bridging (INB) as a morphologic feature in myelodysplastic syndromes (MDS).
- To explore the potential implications of INB in the pathogenesis of MDS.
- To differentiate MDS with INB from congenital dyserythropoietic anemia type I (CDAI).
Main Methods:
- Morphologic examination of bone marrow and peripheral blood smears from patients with MDS.
- Review of literature concerning morphologic features in MDS and related disorders.
- Comparative analysis of INB in MDS versus CDAI.
Main Results:
- A high incidence of internuclear bridging (INB) was observed in patients with myelodysplastic syndromes (MDS).
- INB suggests an underlying defect in mitotic division in MDS.
- The presence of INB may lead to misdiagnosis of MDS as congenital dyserythropoietic anemia type I.
Conclusions:
- Internuclear bridging (INB) is a notable, albeit subtle, morphologic feature in myelodysplastic syndromes (MDS).
- INB may serve as an indicator of abnormal mitotic division, contributing to the pathophysiology of MDS.
- Recognition of INB is crucial for accurate diagnosis and differentiation from congenital dyserythropoietic anemia type I.