标准化的骨髓评估，风险变量和脊髓塑料综合征和急性髓细胞性白血病的狗的存活率
Standardized bone marrow assessment, risk variables, and survival in dogs with myelodysplastic syndrome and acute myeloid leukemia
影响因子:1.70000
分区:农林科学2区 / 兽医学2区 病理学3区
发表日期:2025 Jan
作者:
Anna M Meredith, Janet Beeler-Marfisi, Olaf Berke, Anthony J Mutsaers, Dorothee Bienzle
摘要
骨髓增生性综合征（MDS）和急性髓细胞性白血病（AML）是造血干细胞的异质性肿瘤，对诊断，分化和预后充满挑战。细胞遗传学和突变分析在人类中很有用，但对于狗来说不可用，在狗中，诊断和分类仍然很大程度上依赖于血液学和形态评估。这项研究的目标是将分类方案应用于髓样肿瘤，并评估与预测变量有关的结果。对实验室数据库的关键字搜索，连续排除标准的应用以及3个审稿人的共识产生了70例带有血液学结果的髓样肿瘤，细胞学结果（11），组织学（14）或两种（45）类型的骨髓标本。根据爆炸百分比和形态，将42例归类为MDS和28例AML。 MD的狗的体重明显降低，血红蛋白浓度和血液爆炸，红细胞大小的变异性和血小板数量较高。使用Kaplan-Meier曲线对具有MDS和AML的狗的中位生存率的估计分别为384和6天（p <.001）。 MDS狗的瞬时死亡风险比AML的狗低约5倍。生存的显着预测变量是体重，白细胞计数，血小板计数和血液爆炸百分比（p <.05）。源自最合适的COX回归模型的危险比（HRS）分别为中性粒细胞，血小板减少和血液爆炸的增加为1.043、0.998和1.061。这项研究的发现表明，血液学和形态变量可用于预测髓样肿瘤的结局。
Abstract
Myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) are heterogeneous neoplasms of hematopoietic stem cells that are challenging to diagnose, differentiate, and prognosticate. Cytogenetic and mutational analyses are useful in humans but unavailable for dogs, where diagnosis and classification still rely largely on hematologic and morphologic assessment. The objectives of this study were to apply a classification scheme to myeloid neoplasms and to assess outcome in relation to predictor variables. Keyword search of a laboratory database, application of sequential exclusion criteria, and consensus from 3 reviewers yielded 70 cases of myeloid neoplasia with hematology results, and cytologic (11), histologic (14), or both (45) types of marrow specimens. Based on blast percentage and morphology, 42 cases were classified as MDS and 28 as AML. Dogs with MDS had significantly lower body weights, hemoglobin concentrations and blood blasts, and higher red blood cell size variability and platelet numbers than dogs with AML. Estimates of median survival using Kaplan-Meier curves for dogs with MDS and AML were 384 and 6 days, respectively (P < .001). The instantaneous risk of death for dogs with MDS was approximately 5× lower than that of dogs with AML. Significant predictor variables of survival were body weight, white blood cell count, platelet count, and percent blood blasts (P < .05). Hazard ratios (HRs) derived from best-fitting Cox regression models were 1.043, 0.998, and 1.061 for increased neutrophils, decreased platelets, and increased blood blasts, respectively. Findings from this study suggest that hematologic and morphologic variables are useful to predict outcomes in myeloid neoplasia.