Novel insights into the biology of myelodysplastic syndromes: excessive apoptosis and the role of cytokines.

Abstract:

:The paradox of myelodysplastic syndromes (MDS) which present with pancytopenias despite cellular bone marrows (BM) was investigated by conducting detailed studies of proliferation and apoptosis in 89 MDS patients. Our results demonstrated a rapid rate of both proliferation as well as apoptosis. Levels of three cytokines, tumor necrosis factor-alpha (TNF-alpha), transforming growth factor-beta (TGF-beta) and interleukin-1 beta (IL-1 beta) were measured in the same patients. High levels of TNF-alpha were found to correlate with high levels of apoptosis in 83 MDS patients (P = 0.0045). We propose a dual role for TNF-alpha (or other cytokines) in the pathogenesis of MDS. On the one hand, TNF-alpha induces apoptosis in the maturing cells causing pancytopenia while on the other, it stimulates the proliferation of the primitive progenitors accounting for the hypercellular BM frequently seen in MDS. A new model for MDS is presented. The initial abnormality probably affects a primitive hemopoietic progenitor which acquires a growth advantage leading to monoclonal hemopoiesis, which in turn makes these cells susceptible towards acquiring additional mutations and appearance of cytogenetically marked (or unmarked) clones. Cytokines such as TNF-alpha whose source is presently unknown, then contribute towards the clinical syndrome of pancytopenia and hypercellularity.

journal_name

Int J Hematol

authors

Raza A,Mundle S,Shetty V,Alvi S,Chopra H,Span L,Parcharidou A,Dar S,Venugopal P,Borok R,Gezer S,Showel J,Loew J,Robin E,Rifkin S,Alston D,Hernandez B,Shah R,Kaizer H,Gregory S

doi

10.1016/0925-5710(96)00455-0

subject

Has Abstract

pub_date

1996-06-01 00:00:00

pages

265-78

issue

4

eissn

0925-5710

issn

1865-3774

pii

0925571096004550

journal_volume

63

pub_type

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