[Immunological indices in myelodysplastic syndromes]

Several studies aiming to describe the immunological abnormalities occurring in patients affected by myelodysplastic syndromes (MDS) have been carried out in recent years. We report on the immunological abnormalities found in 22 myelodysplastic patients at the time of diagnosis (RA: 2 cases; ASIA: 4 cases; AREB: 6 cases; AREB-T: 6 cases. LMMC: 4 cases). Matched with similarly aged healthy people (controls) all our patients revealed a significant lymphocytopenia mainly due to a reduction both in number and percentage of T-helper series with decreased OK T4/OK T8 ratio as a result; even B-cells were reduced in number but their percentage still overlapped with the controls. Out of 22 patients, 13 showed hypergammaglobulinemia (polyclonal in 12 cases, monoclonal in the one left) and 2 read positive for Coomb's and Ana-test respectively. The involvement of T-cell immunity in the course of MDS can be explained if we consider the clonal origin of such diseases. Among myelodysplastic patients the ones affected by LMMC, AREB and AREB-T show the heaviest immunological abnormalities: in these cases the whole of T-cells subsets and NK cells as well are affected. Eventually, the mentioned abnormalities are of paramount importance to explain how easily these patients can develop both severe infectious diseases and abrupt acute leukemia.