Increased proportion and altered properties of intermediate monocytes in the peripheral blood of patients with lower risk Myelodysplastic Syndrome

Blood Cells Mol Dis. 2021 Feb;86:102507. doi: 10.1016/j.bcmd.2020.102507. Epub 2020 Sep 28.


Immune deregulation has a critical role in the pathogenesis of lower risk myelodysplastic syndromes (MDS). The cells of the macrophage/monocyte lineage have been reported to contribute to the inflammatory process in MDS through impaired phagocytosis of the apoptotic hemopoietic cells and abnormal production of cytokines. In the present study we assessed the number of peripheral blood (PB) monocyte subsets, namely the classical CD14bright/CD16-, intermediate CD14bright/CD16+ and non-classical CD14dim/CD16+ cells, in patients with lower risk (low/intermediate-I) MDS (n = 32). We also assessed the production of tumor necrosis factor (TNF)α by patient PB monocytes in response to immune stimulus as well as their transcriptome profile. Compared to age- and sex-matched healthy individuals (n = 19), MDS patients had significantly lower number of classical and increased number of intermediate monocytes. Patient intermediate monocytes displayed increased production of TNFα following stimulation with lipopolysaccharide, compared to healthy individuals. Transcriptional profiling comparison of CD16+ monocytes from patients and controls revealed 43 differentially expressed genes mostly associated with biological pathways/processes relevant to hemopoiesis, immune signaling and cell adhesion. These data provide evidence for the first-time that distinct monocyte subsets display abnormal quantitative and functional characteristics in lower risk MDS substantiating their role in the immune deregulation associated with the disease.

Keywords: Immune deregulation; Intermediate monocytes; Monocytes; Myelodysplastic Syndromes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Leukocyte Count
  • Lipopolysaccharide Receptors / analysis*
  • Male
  • Middle Aged
  • Monocytes / pathology*
  • Myelodysplastic Syndromes / blood
  • Myelodysplastic Syndromes / etiology
  • Myelodysplastic Syndromes / pathology*
  • Receptors, IgG / analysis*
  • Risk Factors
  • Tumor Necrosis Factor-alpha / analysis


  • Lipopolysaccharide Receptors
  • Receptors, IgG
  • Tumor Necrosis Factor-alpha