Myelodisplastik sendrom olgularımızın genel ve morfolojik özellikleri ile eritropoetin tedavisine yanıtlarının değerlendirilmesi

Amaç: Kliniğimize başvuran ve MDS tanısı konulan hastaların klinik özelliklerini, periferik kan ve kemik iliği bulgularını ve uygulanan tedavilere verdikleri yanıtları değerlendirmeyi amaçladık. Yöntem: MDS tanısı konulan 45 olgu (29 kadın, 26 erkek) çalışmaya alındı. Morfolojik olarak; diseritropoez, disgranülopoez ve dismegakaryopoez bulguları değerlendirildi. Bulgular: Çalışmamıza alınan 45 olgunun 29’u (% 64.4) kadın, 16’sı (% 35.6) erkek idi. 6 (% 13) olguda hepatomegali, 2 (% 4.5) olguda lenfadenopati ve 6 (% 13) olguda splenomegali bulundu. 38 (% 84.5) olguda anemi, 7 (% 15.5) olguda lökopeni, 13 (% 29) olguda trombositopeni ve 22 (% 49) olguda pansitopeni vardı. Periferik yayma değerlendirmesinde karşılaşılan en önemli diseritropoez bulgusu 37 (% 82) olguda karşılaşılan anizositoz, en önemli disgranülopoez bulgusu 17 (% 38) olguda karşılaşılan hipogranülasyon ve en önemli distrombopoez bulgusu ise; 21 (% 46.5) olguda karşılaşılan dev trombositlerin varlığı idi. Kemik iliği incelemesinde saptanan en önemli diseritropoez bulgusu 29 (% 64.4) olguda saptanan megaloblastik değişim, en önemli disgranülopoez bulgusu 13 (% 28.8) olguda saptanan hipogranülasyon ve en önemli dismegakaryopoez bulgusu 14 (% 31) olguda karşılaşılan mikromegakaryositler idi. Eritropoetin uygulanan 38 olgunun 18’inde (% 47) tedaviye yanıt alınırken 20 olguda (% 53) yanıt alınamadı. Sonuç: Eritropoetin, anemisi olan MDS olgularında transfüzyon ihtiyacını azaltan veya tümden ortadan kaldırabilen etkili bir ilaçtır. Anemi ile prezente olan MDS olgularında ilk tercih olarak dikkate alınması önerilir.

Anahtar Kelimeler:

Miyelodisplastik sendromlar, Eritropoietin, Anemi

Evaluation of general and morphological features of myelodysplastic syndrome patients and their response to erythropoetin administration

Objective: We evaluated clinical features of patients, and morphological features of peripheral blood and bone marrow, and response to treatment. Methods: Forty-five patients (29 female, 26 male), diagnosed MDS were included in this study. Dyserythropoesis, dysgranulopoesis, and dysthrombopoesis finding were evaluated morphologically. Results: Forty-five patients included in this study were consisted of 29 females (64.4%) and 16 males (35.6%). In physicial examination we detected hepatomegaly in 6 patients (13%), lymphadenopaty in 2 patients (4.5%), splenomegaly in 6 patients (13%). In laboratory examination anemia, leukopenia, thrombocytopenia, and pancytopenia were found in 38 (84.5%), 7 (15.5%), 13 (29%), and 22 (49%) patients, respectively. The most important dyserythopoesis, dysgranulopoesis, and dysthrombopoesis findings of patients were anisocytosis in 37 patients (82%), hypogranulation in 17 patients (38%), and giant thrombocytes in 21 patients (46.5%). The most important dyserythropoesis, dysgranulopoesis, and dysthrombopoesis findings of bone marrow of patients were megaloblastic changes in 29 patients (64.4%), hypogranulation in 13 patients (28.8%), and micromegakaryocytes in 14 patients (31%). While we got a good response in 18 patients (47%) using erythropoietin out of 38, we could not get a response in 20 patients (53%). Conclusion: Erythropetin is a drug which can decrease transfusion needs or totally prevent transfusion. Its use is recommended as a first line treatment in MDS patients presented with anemia.

Keywords:

Myelodysplastic Syndromes, Erythropoietin, Anemia,

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