Síndromes mieolodisplásicos.

Abstract

SUMMARYEigtheen patients with Myelodysplastic Syndrome were studied between Jan 84 to Dec 90 at the Hospital Nacional Cayetano Heredia. Ten patients were female and eight were males. The average age was 61.1 years. Sixty one had pancytopenia all patients presented anemia; 83% thrombocytopenia and 65% neutropenia. Bone marrow study showed hyper or normocelularities; 85% of the patients had diseritropiesis and 89% presented dismegacariopoiesis (micromegacariocities). According with FAB classification 44% had refractary anemia, (RA) 11% anemia with ring sidroblasts (RARS), 16.7% refractary anemia with blast in excess (RABE), 22.2% refractary anemia with blast in excess on transformation (RABE t) and 5.5% was diagnosed like chronic myelomonocitic leukemia (CMML). Five patients (27.8%) changed to another variety, four of these patients (22.2%) shifted to acute myeloid leukemia (AML). One patient with abnormal localization of precursors on bone marrow biopsy shifted to AML. The more frecuent complications were infections (45.8%), 16.6% of the patients had bleeding in the central nervous system. The mean survival time the diagnostic was 9.2 months. (Rev Med Hered 1993, 4:12-19) KEY WORDS: Myelodysplastic sindrome, pancytopenia, refractary anemia, anemia, neutropenia, thrombocytopenia. RESUMENEstudiamos retrospectivamente a 18 pacientes con síndrome mielodisplásico (SMD) en un período de 7 años (Enero de 1984 y Diciembre de 1990) en el Hospital Nacional Cayetano Heredia. Diez fueron mujeres y ocho, varones, la edad promedio fue de 61.1 años, El 61% presentó pancitopenia; todos presentaron anemia, 83% trombocitopenia y el 65% neutropenia. Las médulas óseas fueron hiper o normocelulares; 95% de los pacientes presentó diseritropoiesis y el 89% presentó dismegacariopoiesis micromegacarocitos. De acuerdo a la clasificación FAB 44% presentó anemia refractaria (AR), 11% anemia refractaria con sideroblastos en anillos (ARSA), 16.7% anemia refractaria con exceso de blastos (AREB), 22.2% con anemia refractaria con exceso de blastos en transformación