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Peripheral blood neutrophil morphology reflects bone marrow dysplasia in myelodysplastic syndromes
S Widell1, E Hellström-Lindberg, Y Kock
1Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
Abstract:
Dysplastic features of cells in peripheral blood and bone marrow were studied in 51 patients with myelodysplastic syndromes (MDS) to evaluate the significance of the degree of neutrophil granulation (G-score) and the percentage of pelgeroid polymorphs (ppp) in the peripheral blood, as indices of dysplastic changes in the bone marrow. There was a good correlation between peripheral blood and bone marrow findings, both for G-score figures (r = 0.92, P < 0.01) and ppp (r = 0.82, P < 0.01). Significantly lower G-score figures were found among patients with an increased percentage of bone marrow blasts (P < 0.05), while high ppp correlated with the presence of ring sideroblasts, the degree of bone marrow fibrosis, and findings of complex chromosomal abnormalities. Patients with a high degree of bone marrow dysplasia had significantly lower G-score (P < 0.01) and significantly higher ppp (P < 0.05) figures, than those with less pronounced myelodysplasia. In addition, extreme hypogranulation (G-score < 150) or very high ppp (> or = 20%) was generally a sign of bi- and tri-lineage dysplasia in the bone marrow. The results thus show that quantitative estimation of peripheral blood polymorph dysplasia by G-score figures and ppp seems to reflect the total degree of bone marrow dysplasia in MDS and may serve as a complement to bone marrow evaluation when the diagnosis of MDS is difficult.
Insights
Quantitative analysis of peripheral blood cell dysplasia, using neutrophil granulation (G-score) and pelgeroid polymorphs (ppp), effectively reflects bone marrow dysplasia in myelodysplastic syndromes (MDS). These markers aid in MDS diagnosis when bone marrow evaluation is challenging.
Area of Science:
- Hematology
- Oncology
- Cellular Pathology
Background:
- Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic stem cell disorders.
- Assessing dysplasia in peripheral blood can offer insights into bone marrow pathology.
- Quantifying specific morphological features may improve diagnostic accuracy in MDS.
Purpose of the Study:
- To evaluate the significance of neutrophil granulation (G-score) and pelgeroid polymorphs (ppp) in peripheral blood as indicators of bone marrow dysplasia in MDS.
- To correlate peripheral blood findings with bone marrow blast percentage, ring sideroblasts, fibrosis, and chromosomal abnormalities.
Main Methods:
- Studied 51 patients diagnosed with myelodysplastic syndromes (MDS).
- Quantitatively assessed neutrophil granulation (G-score) and percentage of pelgeroid polymorphs (ppp) in peripheral blood.
- Correlated peripheral blood parameters with bone marrow findings, including blast percentage and dysplasia severity.
Main Results:
- Strong correlations were observed between peripheral blood G-score and ppp with bone marrow findings (r = 0.92 and r = 0.82, respectively).
- Lower G-score correlated with increased bone marrow blasts, while higher ppp correlated with ring sideroblasts and chromosomal abnormalities.
- Patients with higher overall bone marrow dysplasia showed significantly lower G-score and higher ppp.
Conclusions:
- Quantitative estimation of peripheral blood polymorph dysplasia using G-score and ppp effectively reflects the overall degree of bone marrow dysplasia in MDS.
- These peripheral blood indices can serve as valuable complements to bone marrow evaluation, particularly in difficult MDS diagnoses.
- Specific thresholds for G-score and ppp may indicate multi-lineage dysplasia in the bone marrow.