Leukocyte Alkaline Phosphatase Score Correlation with Bone Marrow Blast Percentage in Myelodysplastic Syndrome

2010 ◽  
Vol 124 (3) ◽  
pp. 179-181
Author(s):  
Jay Lipshitz ◽  
Sewanti Limaye ◽  
Dilip Patel
Keyword(s):  
Bone Marrow ◽  
Alkaline Phosphatase ◽  
Myelodysplastic Syndrome ◽  
Bone Marrow Blast ◽  
Leukocyte Alkaline Phosphatase

Leukocyte Alkaline Phosphatase Score as a Marker of Severity and Progression of Myelodysplastic Syndrome.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4625-4625 ◽  
Author(s):  
Jay Lipshitz ◽  
Sewanti Limaye ◽  
Dilip Patel
Keyword(s):  
Bone Marrow ◽  
Alkaline Phosphatase ◽  
Myelodysplastic Syndrome ◽  
Disease Activity ◽  
Disease Progression ◽  
Myelogenous Leukemia ◽  
Bone Marrow Blast ◽  
Leukocyte Alkaline Phosphatase ◽  
Significant Difference ◽  
Bone Marrow Blasts

Abstract Leukocyte Alkaline Phosphatase (LAP) Score is valuable in the work-up of certain hematological diseases. Most notably, the score is decreased in Chronic Myelogenous Leukemia and Paraoxysmal Nocturnal Hemaglobinurea but increased in leukemoid reaction to infection and Polycythemia Vera. Last year we reported the LAP scores of 14 patients with Myelodysplastic Syndrome (MDS). Our results showed that patients with less than 5% bone marrow blasts had significantly higher LAP scores than patients with 5–19% bone marrow blasts. We raised the possibility that LAP scores decrease as MDS progresses (Blood, Nov 2006; 108: 4865). In the present study we attempt to further evaluate the utility of LAP in MDS. In addition to our original cohort, bone marrow aspirate results and LAP scores were reviewed from 14 more patients with MDS, for a total of 28 patients. We again assessed the relationship of LAP to bone marrow blast percentage. Furthermore, we recorded a second LAP score, taken at a later date, from 16 of the 28 patients. For those patients with two LAP scores we compared the trend of LAP score to the interval activity of MDS, using transfusion requirement, complete blood cell count (CBC) and clinical assessment as markers of disease activity. In our analysis of LAP score relative to bone marrow blast percentage we again found a significant difference between patients with less than 5% blasts (n=8) and those with 5% to19% blasts (n=20). Patients with less than 5% blasts had significantly higher LAP scores (90.25 ± 18.27) than those with 5 to19% blasts (44.35 ± 52.09) (p<0.0048) (see charts 1 and 2). In our analysis of LAP score in relation to disease progression we found that among patients for whom LAP score decreased, 42.9% (3/7) had disease progression. In patients whose LAP score increased, 11.1% (1/9) had disease progression (p<0.2615) (chart 3). Overall, our results confirm that LAP scores do tend to be lower in patients with more severe disease, as assessed by bone marrow blast percentage. However, although a trend was observed toward change in LAP score correlating with disease activity this was not statistically significant, and larger prospective studies are necessary to assess whether LAP is an accurate marker of MDS progression. Chart 1: LAP scores of patients 1 through 8 with bone marrow blasts less than 5% (mean 90.25, median 96) Chart 2: LAP scores for patients 1 through 20 with bone marrow blasts of 5% to 19% (mean 44.35, median 30) Chart 1: LAP scores of patients 1 through 8 with bone marrow blasts less than 5% (mean 90.25, median 96) . / Chart 2: LAP scores for patients 1 through 20 with bone marrow blasts of 5% to 19% (mean 44.35, median 30) Chart 3: Percent of patients with disease progression among those with decrease in LAP score (white) and those with increase in LAP score (gray) (p<0.2615). Chart 3: Percent of patients with disease progression among those with decrease in LAP score (white) and those with increase in LAP score (gray) (p<0.2615).

Leukocyte Alkaline Phosphatase Score in Myelodysplastic Syndrome: A Comparison of Patients with Normal and Abnormal Proportions of Bone Marrow Blasts.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4865-4865
Author(s):  
Jay Lipshitz ◽  
Natalie Tafel ◽  
Dilip Patel
Keyword(s):  
Bone Marrow ◽  
Alkaline Phosphatase ◽  
Myelodysplastic Syndrome ◽  
Refractory Anemia ◽  
Bone Marrow Blast ◽  
Ringed Sideroblasts ◽  
Non Invasive ◽  
Leukocyte Alkaline Phosphatase ◽  
The Mean ◽  
Bone Marrow Blasts

Abstract The expression of leukocyte alkaline phosphatase (LAP) in neutrophils has been shown to be reduced in some patients with myelodysplastic syndrome (MDS), but increased in the refractory anemia (RA) subtype. We performed a retrospective study looking at the LAP scores of 14 patients with MDS. Patients were grouped according to bone marrow blast percentage. Those with less than 5% blasts in the marrow (refractory anemia and refractory anemia with ringed sideroblasts) comprised one group (n=7) and those with 5% to 19% blasts (refractory anemia with excess blasts) comprised a second group (n=7). LAP scores in the group with fewer than 5% blasts were significantly higher (range 71 to 116, mean 93.6) than LAP scores in the 5%–19% group (range 2 to 46, mean 26.6) (p&lt;0.0001). Our results suggest that LAP score may correlate with disease severity in MDS. If this finding is confirmed in larger prospective studies then LAP score may be a useful, relatively non-invasive aide in assessing the course and progression of myelodysplastic syndrome. LAP Scores for Patients 1 through 7 in the Groups “Marrow Blasts &lt;5%” and “Marrow Blasts 5%–19%” 1 2 3 4 5 6 7 The LAP scores of the two groups differed significantly (p&lt;0.0001). The mean for the “Blasts&lt;5%” group was 93.6 (SD=16.9), and the mean of the “Blasts 5%–19%” group was 26.6 (SD=7.1). There was no crossover between groups, in that the lowest LAP score in the &lt;5% group was 25 points higher than the highest LAP score in the 5%–19% group. Blasts &lt; 5% 91 76 88 103 116 71 90 Blasts 5%–19% 16 45 30 42 5 2 46

scholarly journals Integration Analysis of JAK2 or RUNX1 Mutation With Bone Marrow Blast Can Improve Risk Stratification in the Patients With Lower Risk Myelodysplastic Syndrome

2021 ◽  
Vol 10 ◽  
Author(s):  
Ying Fang ◽  
Juan Guo ◽  
Dong Wu ◽  
Ling-Yun Wu ◽  
Lu-Xi Song ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Risk Stratification ◽  
Myelodysplastic Syndrome ◽  
Lower Risk ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
International Prognostic Scoring System ◽  
Bone Marrow Blast ◽  
Improve Risk Stratification ◽  
Mutational Status

Despite the improvements in prognostication of the revised International Prognostic Scoring System (IPSS-R) in myelodysplastic syndrome (MDS), there remain a portion of patients with lower risk (low/intermediate risk, LR) but poor prognostics. This study aimed to evaluate the relative contribution of mutational status when added to the IPSS-R, for estimating overall survival (OS) and progression-free survival (PFS) in patients with LR-MDS. We retrospectively analyzed clinical and laboratory variables of 328 patients diagnosed with MDS according to the FAB criteria. Twenty-nine-gene NGS assay was applied to bone marrow samples obtained at diagnosis. 233 (71.04%) patients were classified as LR-MDS. Univariate analysis showed association between inferior outcome (OS and PFS) and presence of JAK2 (p = 0.0177, p = 0.0002), RUNX1 (p = 0.0250, p = 0.0387), and U2AF1 (p = 0.0227, p = 0.7995) mutations. Multivariable survival analysis revealed JAK2 (p &lt; 0.0001) and RUNX1 (p = 0.0215) mutations were independently prognostic for PFS in LR-MDS. Interestingly, bone marrow blast &gt;1.5% could further predict disease progression of patients with LR-MDS (HR 8.06, 95%CI 2.95–22.04, p &lt; 0.0001). Incorporation of JAK2, RUNX1 mutation and bone marrow blast in the IPSS-R can improve risk stratification in patients with LR-MDS. In summary, our result provided new risk factors for LR-MDS prognostics to identify candidates for early therapeutic intervention.

Correlation of overall survival (OS) with bone marrow blast (BMBL) response in patients (pts) with myelodysplastic syndrome.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 7017-7017
Author(s):  
Lewis R. Silverman ◽  
Pierre Fenaux ◽  
Peter Greenberg ◽  
Erin P Demakos ◽  
Valeria Santini ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Overall Survival ◽  
Myelodysplastic Syndrome ◽  
Bone Marrow Blast

Diagnosis and Management of Anemia in Patients with the Myelodysplastic Syndrome

1998 ◽  
Vol 5 (2_suppl) ◽  
pp. 41-45 ◽  
Author(s):  
John M. Bennett ◽  
Peter A. Kouides
Keyword(s):  
Bone Marrow ◽  
Blood Cell ◽  
Myelodysplastic Syndrome ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Recombinant Erythropoietin ◽  
Bone Marrow Blast ◽  
Diagnosis And Management ◽  
Specific Factors

While not appropriate for all patients with the myelodysplastic syndrome, recombinant erythropoietin (EPO) is a possible alternative to red blood cell transfusion. Specific factors such as the presence of cytopenias, the bone marrow blast percentage, and cytogenetic findings determine which patients are good candidates for treatment with EPO.

scholarly journals A clinicopathologic correlation of the idiopathic hypereosinophilic syndrome. I. Hematologic manifestations

Blood ◽  
1981 ◽  
Vol 58 (5) ◽  
pp. 1012-1020 ◽  
Author(s):  
MA Flaum ◽  
RT Schooley ◽  
AS Fauci ◽  
HR Gralnick
Keyword(s):  
Bone Marrow ◽  
Alkaline Phosphatase ◽  
Peripheral Blood ◽  
Scoring System ◽  
Hypereosinophilic Syndrome ◽  
Grading System ◽  
Idiopathic Hypereosinophilic Syndrome ◽  
Cytotoxic Therapy ◽  
Leukocyte Alkaline Phosphatase ◽  
Or Groups

A retrospective blind study of 32 patients with the hypereosinophilic syndrome was undertaken utilizing a hematologic scoring system that was based on peripheral blood and bone marrow findings, cytogenetics B12 levels, and leukocyte alkaline phosphatase determinations. In addition to the grading system, which allowed formulation of a hematologic score, the date could also be normalized for individuals who did not have all tests performed by use of the hematologic quotient. This study clearly defined two groups of patients within the idiopathic hypereosinophilic syndrome. One group were those individuals with low hematologic scores and quotients who did not require therapy or who responded to prednisone therapy, while the second group of patients required cytotoxic therapy. These patients had significantly higher hematologic scores and quotients and a significant number of abnormalities similar to those seen in myeloproliferative syndromes, such as myelofibrosis and cytogenetic abnormalities. This type of hematologic scoring seems useful in predicting therapy and/or evaluating individuals or groups of patients with the hypereosinophilic syndrome.

scholarly journals Dyskeratosis Congenita: Relationship to Fanconi’s Anemia

Blood ◽  
1972 ◽  
Vol 39 (4) ◽  
pp. 510-521 ◽  
Author(s):  
William Steier ◽  
G. Arthur Van Voolen ◽  
Victor J. Selmanowitz
Keyword(s):  
Bone Marrow ◽  
Alkaline Phosphatase ◽  
Dyskeratosis Congenita ◽  
Lacrimal Duct ◽  
Hemoglobin F ◽  
Fanconi's Anemia ◽  
Leukocyte Alkaline Phosphatase ◽  
Thyroglobulin Antibody ◽  
Fanconi’S Anemia ◽  
Growth Evaluation

Abstract Dyskeratosis congenita and Fanconi’s anemia share impressive features in common: primary refractory pancytopenia; bone marrow hyperplasia (curtailed phase) and megaloblastosis, eventuating in severe hypoplasia of the marrow; cutaneous melanotic dyschromia; lacrimal duct blockage and a host of other minor abnormalities, in addition to mental retardation and generalized impairment of growth. Evaluation of two brothers with dyskeratosis congenita, and review of previous reports, indicate the following to be more prominent in dyskeratosis congenita than in Fanconi’s anemia: cutaneous telangiectatic erythema and atrophy; exocrine, ungual, and dental dysplasias; mucosal leukoplakia, carcinomatosis, and stenosis; and esophageal diverticula. Prominent in Fanconi’s anemia but not dyskeratosis congenita are the renal and particular skeletal anomalies. Possible transition cases are discussed. The proband studied suffered from progressive refractory pancytopenia, fevers, abdominal pains, malabsorption syndrome, and finally subarachnoid hemorrhage. Cultured leukocytes had normal-appearing karyotypes. The proband’s brother had cutaneous alterations of dyskeratosis congenita, but a hemogram revealed only mild thrombocytopenia and macrocytosis. Both brothers had elevated levels of hemoglobin F, leukocyte alkaline phosphatase, serum IgG, and thyroglobulin antibody, and both had reduced levels of serum IgM and vitamin B12.

scholarly journals Trisomy of Group C in a Myeloproliferative Disorder

Blood ◽  
1966 ◽  
Vol 27 (5) ◽  
pp. 722-733 ◽  
Author(s):  
ALAN WINKELSTEIN ◽  
ROBERT S. SPARKES ◽  
CHARLES G. CRADDOCK
Keyword(s):  
Bone Marrow ◽  
Alkaline Phosphatase ◽  
Phosphatase Activity ◽  
Alkaline Phosphatase Activity ◽  
Myeloproliferative Disorder ◽  
Metaphase Chromosomes ◽  
Myeloproliferative Syndrome ◽  
Leukocyte Alkaline Phosphatase ◽  
Extramedullary Erythropoiesis

Abstract A patient with an atypical myeloproliferative syndrome characterized by leukocytosis with myeloid immaturity, ineffective extramedullary erythropoiesis, overt hemolysis and low leukocyte alkaline phosphatase activity demonstrated a trisomy in the C group of bone marrow metaphase chromosomes.

scholarly journals Post-Transplantation Cyclophosphamide for Graft-Versus-Host Disease Prophylaxis in Allogeneic Hematopoietic Cell Transplantation for Higher-Risk Myelodysplastic Syndrome

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2873-2873
Author(s):  
Eun-Ji Choi ◽  
Han-Seung Park ◽  
Jung-Hee Lee ◽  
Kyoo Hyung Lee ◽  
Youngshin Lee ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Myelodysplastic Syndrome ◽  
Acute Gvhd ◽  
Hematopoietic Cell Transplantation ◽  
Advisory Board ◽  
Bone Marrow Blast ◽  
Post Transplantation ◽  
Graft Versus Host ◽  
Allogeneic Hct ◽  
Gvhd Prophylaxis

Abstract Introduction: Allogeneic hematopoietic cell transplantation is an only potentially curative option for patients with higher-risk myelodysplastic syndrome (MDS). Owing to the advances in treatment strategies including reduced intensity conditioning, graft-versus-host disease (GVHD) prevention and supportive care, more elderly patients or those with comorbidities can proceed to allogeneic HCT. However, the long-term survival rate following allogeneic HCT is reported to be less than 50%, and non-relapse mortality (NRM) rate is still high reaching upto 30%. In this study, we aimed to evaluate the feasibility of using post-transplantation cyclophosphamide (PTCy) as a GVHD prophylaxis in allogeneic HCT for higher-risk MDS patients. We also compared the post-transplantation outcomes of PTCy group and those of historical control who received HCT using anti-thymocyte globulin (ATG). Methods: Patients with higher-risk MDS or MDS/myeloproliferative neoplasm (MPN) with bone marrow blast ≥ 5% were included in this study. Higher-risk MDS was defined by MDS with International Prognostic Scoring System &gt;1.0 or bone marrow blast ≥ 5% at any time points before HCT. Conditioning regimen consists of busulfan (4-days for patients aged &lt;55 years, 2-days for 55 years), fludarabine. For GVHD prophylaxis, PTCy (50 mg/kg on days 3 and 4), cyclosporine, and mycophenolate mofetil were administered. In historical group, patients received 2- or 4-days of busulfan, fludarabine, and ATG with short course of methotrexate and cyclosporine. Results: Ninety-two and 144 patients received allogeneic HCT using PTCy and ATG, respectively. The median overall survival were 47.9 and 44.0 months, respectively (P=.383). Cumulative incidence of total and grade II-IV acute GVHD in PTCy and ATG group were 19.6% vs. 37.5% (P=.002), and 2.6% vs. 21.7% (P&lt;.001), respectively. Incidence of total and extensive chronic GVHD (50.0% vs. 49.1%, P=.567; 32.5% vs. 33.4%, P=.581), 1-year NRM (20.8% vs. 22.9%, P=.702), and 2-year relapse (16.0% vs. 18.1%, P=.605) were not different between two groups. Neutrophil and platelet engraftment was significantly faster with ATG than PTCy (median 12 vs. 15 for neutrophil; median 15 vs. 24 days for platelet). Conclusion: Allogeneic HCT using PTCy as GVHD prophylaxis in higher-risk MDS seems feasible in terms of low rate of acute GVHD and relapse incidence. Disclosures Choi: Ingenium Therapeutics, Daejeon, Korea: Consultancy, Current holder of individual stocks in a privately-held company. Lee: Ingenium Therapeutics, Daejeon, Korea: Consultancy, Current holder of individual stocks in a privately-held company. Lee: Korean Society of Hematology: Membership on an entity's Board of Directors or advisory committees; Astellas Pharma, Inc.: Consultancy, Honoraria, Other: Advisory board; AbbVie: Honoraria, Other: Advisory board.

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