Myelodysplasia syndrome

From Dog
(Redirected from Myelodysplastic syndrome)

Myelodysplasia is an acquired hematopoietic stem cell disorder of dogs characterized by clonal proliferation of erythroid myeloblasts from bone marrow.

The disease, which presents clinically as a normocytic, normochromic non-regenerative anemia, may be a primary disorder, or occur as a secondary phenomenon due to other underlying disease(s) processes.

In humans, karyotyping and molecular genetic analysis are used to diagnose this condition but in veterinary medicine, such techniques are rarely available, therefore a less accurate method is employed[1].

Specifically, dogs with less than 30% of cells present on histopathological examination of bone marrow samples are myeloblasts, this is termed myelodysplasia. In cases where > 30% of bone marrow cells are myeloblasts, this is usually categorized as leukemia.

There are three loose categories of myelodysplasia recognized in dogs:

  • Myelodysplastic syndrome with refractory cytopenia (<6% myeloblasts) - anemia, no pancytopenia, usually secondary to other diseases
  • Myelodysplastic syndrome with excess myeloblasts (6 - 30% myeloblasts) - anemia, leukopenia, thrombocytopenia, usually primary[2]
  • Myelodysplastic syndrome with sideroblastic differentiation (6 - 30% myeloblasts)[3]

When myeloblasts and monoblasts together constitute more than 30% of all nucleated cells in the bone marrow, and differentiated granulocytes and monocytes each comprise more than 20% of all nucleated cells, the definition is acute myelomonocytic leukemia[4].

Cell morphology alone cannot be used to distinguish primary and secondary myelodysplastic syndromes in dogs[5].

Secondary conditions associated with myelodysplasia include:

Dogs with refractory cytopenias tend to be clinically stable when first evaluated, have a better response to erythropoietin, blood transfusions, prednisolone and vitamin supplementation therapy and longer survival times[6], compared with dogs with primary myelodysplasia with excess myeloblasts which have short survival and do not respond to standard treatments.

Chemotherapy trials, using hydroxyurea, cytosine arabinoside or aclarubicin have only limited success.

References

  1. Juopperi TA et al (2011) Prognostic markers for myeloid neoplasms: a comparative review of the literature and goals for future investigation. Vet Pathol 48(1):182-197
  2. Weiss DJ & Smith SA (2000) Primary myelodysplastic syndromes of dogs: a report of 12 cases. J Vet Intern Med 14(5):491-4
  3. Weiss DJ & Lulich J (1999) Myelodysplastic syndrome with sideroblastic differentiation in a dog. Vet Clin Pathol 28(2):59-63
  4. Hisasue M et al (2008) A dog with acute myelomonocytic leukemia. J Vet Med Sci 70(6):619-621
  5. Weiss DJ & Aird B (2001) Cytologic evaluation of primary and secondary myelodysplastic syndromes in the dog. Vet Clin Pathol 30(2):67-75
  6. Lukaszewska J & Lewandowski K (2008) Cabot rings as a result of severe dyserythropoiesis in a dog. Vet Clin Pathol 37(2):180-183