Characterization of the erythropoiesis in myelodysplasia by means of ferrokinetic studies, in vitro erythroid colony formation and soluble transferrin receptor

Abstract

In refractory anemia (RA) and refractory anemia with ringed sideroblasts (RARS) a discrepancy is observed between the decreased in vitro erythroid colony formation and the normal or increased number of normoblasts in the bone marrow. 05). Most of the cases (73%) with increased ETU valuesshowed an augmented percentage of erythroblasts in the bone marrow, which was inversely related with the serum Epo levels (P Ͻ 0.05, r ‫؍‬ 0.51). However no correlation was found between the ETU values and the in vitro erythroid colony formation. Transfusion dependency was associated with normal to increased ETU levels (P Ͻ 0.05) and cytogenetic abnormalities (P Ͻ 0.05). These observations demonstrate that different patterns of defects can be observed in the erythropoiesis of RA and RARS patients whereby normal to increased ETU levels and the presence of cytogenetic abnormalities differentiate between cases of RA with ineffective erythropoiesis associated with regular transfusions and cases who are relatively transfusion independent.

The significance of soluble transferrin receptors in diagnosing iron deficiency anemia

“…In patients with MDS, 25% of patients had higher sTfR values. The data found in literature also indicate that higher, normal or lower values of sTfR level may be registered in MDS patients, reflecting various models of erythropoiesis that may be found in these patients [25]. In 14.3% of patients with multiple myeloma we found higher sTfR levels, while 85.7% had the normal values, that being in accordance with the literature [24].…”

Soluble transferrin receptor for the evaluation of erythropoiesis and iron status

“…Soluble TfR levels are elevated in patients with myelofibrosis and myeloproliferative disorders, but are essentially within the normal range in chronic myelogenous leukemia or essential thrombocythemia, which is in keeping with our understanding of erythropoiesis in these disorders [12,130]. Patients with MDS may have decreased, normal or elevated levels, reflecting the various patterns of erythropoiesis encountered in these disorders [12,15,131,132]. In patients with polycythemia vera, sTfR levels may be considerably elevated [12], although this may be partly because of phlebotomy-induced iron depletion.…”

Erythroid progenitors from patients with low-risk myelodysplastic syndromes are dependent on the surrounding micro environment for their survival

“…In vitro culture assay The erythroid burst-forming unit (BFU-E) assay was performed in duplicate in methylcellulose (MethoCult H4230, StemCell Technologies, Grenoble, France) supplemented with 1 U erythropoietin (EPO; Cilag Eprex, Brussels, Belgium) as previously described [14]. After 14 days, BFU-E were counted.…”