Comparison of immunological abnormalities of lymphocytes in bone marrow in myelodysplastic syndrome (MDS) and aplastic anemia (AA)

Intern Med. 2010;49(14):1349-55. doi: 10.2169/internalmedicine.49.3477. Epub 2010 Jul 15.


Objective: The subsets and the polarization of lymphocytes in bone marrow from low-risk myelodysplastic syndrome (MDS) were studied and compared with those from patients with aplastic anemia (AA).

Methods: A total of 34 patients with low-risk MDS (IPSS score< or =1.0) who presented abnormal chromosomes and 16 patients with AA were enrolled in this study. We determined T lymphocyte subsets, T cells polarization status, and the percentages of NK cells and of B lymphocytes in bone marrow and compared these parameters between the two groups of patients. As controls, 24 patients with high-risk MDS (IPSS score>1.0) presenting abnormal chromosomes and 22 healthy/benign hematologic disease subjects were used.

Results: In low-risk MDS/AA patients, the percentage of CD3+ lymphocytes was significantly increased compared to controls (p=0.006 and p=0.001), while the percentage of CD19+ lymphocytes was significantly decreased (p<0.001 and p=0.002); there were no significant differences between MDS/AA and normal controls in other parameters; For low-risk MDS patients, the polarization status of bone marrow CD4+ cells toward Th1 (Th1/Th2) and of CD8+ cells toward Tc1 (Tc1/Tc2) was stronger than that for AA patients (p=0.05 and p<0.001). Other parameters did not show significant differences; Regardless of the predominance of CD4 or CD8 T cells, all patients with low-risk MDS were accompanied with elevated Tc1 polarization (Tc1/Tc2).

Conclusion: In both AA and MDS, the number of total T lymphocytes increased. However, polarization towards Th1 and Tc1 was obviously stronger in MDS patients than in AA patients. This might be related to T cell stimulation from the clones of malignant hematopoietic cells.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia, Aplastic / diagnosis
  • Anemia, Aplastic / genetics
  • Anemia, Aplastic / immunology*
  • Bone Marrow / immunology*
  • Bone Marrow / pathology*
  • Child
  • Chromosome Aberrations
  • Female
  • Humans
  • Lymphocyte Subsets / immunology*
  • Lymphocyte Subsets / pathology*
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes / diagnosis
  • Myelodysplastic Syndromes / genetics
  • Myelodysplastic Syndromes / immunology*
  • Young Adult