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Author Spotlight: Analyzing Bone Marrow Microenvironment in Murine Hematological Malignancies
Published on: November 10, 2023
Bone marrow ring sideroblasts in hematological diseases: an analysis of consecutive 1300 samples in a single
Kei Hayama1, Yuka Abe2, Hirotoshi Kamata1
1Department of Hematology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
Abstract:
The incidence of MDS-RS in Japan has been recognized as about 5% which is lower than that in European countries. Insufficient use of iron staining tests in Japan has been noted as one conceivable factor contributing to this apparently lower prevalence. To investigate this issue, we analyzed the proportion of ring sideroblasts (RS) in 1300 bone marrow samples from patients with hematological diseases at Kitasato University Hospital, including iron staining of all samples. Sixteen of 96 patients with MDS (16.7%) were diagnosed with MDS-RS, and this accounted for 26.2% of MDS without excess blasts. Some MDS-EB (22.9%) and AML-MRC (13.8%) patients also had ≥ 15% RS. In contrast, RS were rarely found in myeloid neoplasms without dysplasia and non-myeloid diseases: only 1 in 46 (2.2%) patients with AML without dysplasia, 2 in 93 (2.2%) with MPN, and 8 in 984 (0.8%) with non-myeloid diseases had ≥ 5% RS. These results indicate that prevalence of MDS-RS in Japan may be higher than conventionally recognized and that RS are principally restricted to myelodysplastic disorders. Further multicenter studies using consecutive bone marrow samples with iron staining tests will be required to confirm our findings.
Insights
The prevalence of myelodysplastic syndromes with ring sideroblasts (MDS-RS) in Japan may be underestimated. This study suggests MDS-RS is more common than previously thought and primarily occurs in myelodysplastic disorders.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- The recognized incidence of myelodysplastic syndromes with ring sideroblasts (MDS-RS) in Japan is approximately 5%, lower than in European countries.
- Insufficient utilization of iron staining tests in Japan is a potential reason for the apparently lower prevalence of MDS-RS.
Purpose of the Study:
- To investigate the actual prevalence of MDS-RS in Japan.
- To determine the frequency of ring sideroblasts (RS) in various hematological diseases.
- To clarify the association of RS with specific myeloid neoplasms.
Main Methods:
- Analysis of 1300 bone marrow samples from patients with hematological diseases at Kitasato University Hospital.
- Inclusion of iron staining for all bone marrow samples.
- Classification of patients based on diagnosis, including myelodysplastic syndromes (MDS), myelodysplastic syndromes with excess blasts (MDS-EB), acute myeloid leukemia with myelodysplasia-related changes (AML-MRC), acute myeloid leukemia without dysplasia (AML without dysplasia), myeloproliferative neoplasms (MPN), and non-myeloid diseases.
Main Results:
- 16.7% of MDS patients (16 of 96) were diagnosed with MDS-RS, representing 26.2% of MDS without excess blasts.
- Significant proportions of MDS-EB (22.9%) and AML-MRC (13.8%) patients exhibited ≥15% RS.
- RS were infrequent in AML without dysplasia (2.2%), MPN (2.2%), and non-myeloid diseases (0.8%), indicating RS are primarily associated with myelodysplastic disorders.
Conclusions:
- The prevalence of MDS-RS in Japan might be higher than currently recognized.
- Ring sideroblasts are predominantly found in myelodysplastic disorders.
- Multicenter studies with comprehensive iron staining are needed to validate these findings.
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