Esterase cytochemistry in primary myelodysplastic syndromes and megaloblastic anaemias: demonstration of abnormal staining patterns associated with dysmyelopoiesis

Abstract

Acid alpha naphthyl acetate esterase (ANAE) and combined ANAE-chloroacetate esterase cytochemistry was performed on 121 bone marrow aspirates from primary myelodysplastic syndromes (MDS) and a secondary dysplasia-megaloblastic anaemia (MA). The investigation demonstrated the presence of abnormal ANAE positive granulocyte populations in a significant proportion of cases. These cells, in which the staining patterns were characterized by atypical granular ANAE positivity and double ANAE-chloroacetate reactions, were shown immunologically to lack the receptor and antigenic characteristics of monocytes and morphologically to be granulocytes. Isoelectric focusing, however, indicated that the atypical esterase cytochemistry of these granulocytes was due to the presence of markedly increased concentrations of ANAE isoenzymes usually found in monocytes. Atypical ANAE-staining granulocytes were particularly evident in MDS marrows showing sideroblastic erythroid changes, whilst in MA they were mainly seen in cases of intermediate severity. It is suggested that these cells are associated with dysmyelopoietic changes in both malignant and non-malignant conditions.

Double Esterase Staining andOther Neutrophilic Granule Abnormalities in 237 Patients with the Myelodysplastic Syndrome Studied by the Cancer and Leukemia Group B

“…Bone marrow cells with abnormal DE staining have been described in MDS, chronic myeloproliferative disorders, megaloblastic anemia and acute myeloid leukemia [2, 3]. The definition of positivity for DE varies in different studies from any identifiable cell [2] to >1% [3].…”

“…The definition of positivity for DE varies in different studies from any identifiable cell [2] to >1% [3]. Based on studying a sufficient number of hematologically normal marrows, we used >2% as our threshold.…”

“…DE staining has been reported in MDS, megaloblastic anemia, chronic myeloproliferative disorders and acute leukemia [2, 3]. It has been suggested that, among the subtypes of MDS, DE staining is most common in refractory anemia with ring sideroblasts and the degree of staining correlates with sideroblastosis [3]. In this study, we investigate DE in MDS and correlate DE staining with MDS subtype and with other abnormalities in neutrophilic granules using cytochemical and immunocytochemical studies.…”

“…An additional interesting cytochemical abnormality in MDS is the presence of cells coexpressing double esterase (DE), i.e. both specific and nonspecific esterase [3]. Naphthol-AS-D chloroacetate or specific esterase is an enzyme located in the azurophilic granules and is generally used as a marker for neutrophilic granulocytes and mast cells [4].…”

“…However, more recent studies indicate that this enzyme is present in a soluble form in the lumen of the endoplasmic reticulum [7]. DE staining has been reported in MDS, megaloblastic anemia, chronic myeloproliferative disorders and acute leukemia [2, 3]. It has been suggested that, among the subtypes of MDS, DE staining is most common in refractory anemia with ring sideroblasts and the degree of staining correlates with sideroblastosis [3].…”