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Characterization of myelodysplastic syndrome and aplastic anemia by immunostaining of p53 and hemoglobin F and karyotype analysis: Differential diagnosis between refractory anemia and aplastic anemia
Author(s) -
Iwasaki Takashi,
Murakami Masashi,
Sugisaki Chiho,
Sobue Sayaka,
Ohashi Haruhiko,
Asano Haruhiko,
Suzuki Motoshi,
Nakamura Shigeo,
Ito Masafumi,
Murate Takashi
Publication year - 2008
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.2008.02236.x
Subject(s) - myelodysplastic syndromes , aplastic anemia , immunostaining , anemia , leukemia , pathology , medicine , cytogenetics , bone marrow , staining , karyotype , hemoglobin , biology , immunohistochemistry , chromosome , genetics , gene
P53 mutation has been reported in various solid tumors, acute leukemia and myelodysplastic syndrome (MDS), but the diagnostic significance of p53 in MDS remains to be determined. The purpose of the present paper was to examine p53 mutation and immunostaining of the same patients, because there have been few reports of simultaneous analysis of these markers. Seven p53 mutations were observed among 37 MDS and 11 cases of overt leukemia transformed from MDS (MDS‐OL). Mutated p53 mainly observed in high‐risk MDS had more intense p53 staining than in MDS with wild‐type p53 overexpression. Aplastic anemia (AA) produced no p53 staining. The percentage of p53 staining in MDS (71%) was higher than that of mutated p53 (11%) but did not reach 100% of MDS cases studied, therefore the authors attempted to differentiate MDS, especially refractory anemia (RA) and AA, using a combination of p53 immunostaining, hemoglobin F (HbF) immunostaining and chromosome abnormality, because HbF of erythroblasts was reportedly observed in MDS RA but not in AA. Most MDS/MDS‐OL (47/48) had at least one positive marker. Among 11 AA cases, only two were positive for HbF. The present results suggest that the combination of these three markers is useful to discriminate MDS from AA.