DNA content and cell cycle analysis of bone marrow cells in myelodysplastic syndromes (MDS)

DNA distribution in bone marrow cells from 10 normal subjects and 34 patients with MDS (24 with refractory anaemia (RA) and 10 with excess blasts (RAEB] was determined by flow cytometry using a FACS III. DNA histograms were resolved into G0/1, S and G2/M compartments by fitting Gaussian distributions and the DNA content of G0/1 cells, expressed as DNA index (DI), was determined. In 19 MDS patients the DI was outside the normal range, those with RA tending to be hyperdiploid. Two patients with RAEB had a second G0/1 peak. In five cases of RA the number of cells in G0/1 was below the normal range and the mean value was significantly lower than normal for this group as a whole (P = 0 X 018). Eleven (RA) patients had a higher percentage of cells in G2/M than normal (P = 0 001). In RAEB patients there is a suggestion of increased numbers in G0/1 and a decrease in S phase and G2/M cells. All three of the deaths amongst RA patients and four out of the five deaths in RAEB patients since the beginning of this study were associated with an abnormal DI at the initial investigation.