Page 109 - Haematologica Atlas of Hematologic Cytology

CHAPTER 12 - Myelodysplastic syndromes
Figure 0 0 Myelodysplastic syndrome with isolated del( ) Bone marrow smear from a a a a a 50-ye- ar-old woman presenting macrocytic anemia mild leukopenia and slightly increased platelet count Note at at low magnification normal normal cellularity and several megakaryocytes of normal normal or or or reduced size with a a a a a a a single round or or oval non-lobated or or hypolobated nucleus and granular cyto- plasm AB
Figure 1 Myelodysplas c c c syndrome with isolated del( ) ) ) (A) Most megakaryocytes have round or oval nucleus (B) Macroblastoid intermediate erythroblasts Granuloblas c c c c series was normal no no no excess blasts blasts no no no Auer rods Cytogene cs showed inters al al del(5q) del(5q) as as the the only anomaly The TP53 gene was not mutated In this MDS subtype del(5q) del(5q) occurs either in isola on on or or or with one other other cytogene c c abnormality other other than -7 or or or del(7q) The size of del(5q) varies but bands q31-q33 are always deleted with the the the the loss of of of genes important for the the the the development of of of the the the the characteris c c c features of of of the the the the disease (ane- mia with with with or or without neutropenia and/or thrombocytosis increased megakaryocytes with with with round non-lobated nucleus) MDS with with isolated del(5q) has a a a a a a a a rela vely good prognosis TP53 muta on on is is is is associated with with increased risk of leukemic evolu on on poor response to lenalidomide (that is usually e e e e e e e e e e e ec ve in in suppressing the abnormal clone) and shorter survival 96