The nature of blast cells in myelodisplastic syndromes evolving to acute leukaemia

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Abstract
The blast cells from nine patients with an overt acute leukaemia following a previous myelodisplastic syndrome (MDS) are analyzed with a panel of monoclonal antibodies as well as by morphological and cytochemical criteria. By integrating the results obtained with these three approachs the leukaemia in 6 patients was assessed as myeloid — granulocytic and/or monocytic —, in two as mixed — megakaryoblastic/myeloid — and in one as lymphoid. A good correlation between morphology, cytochemistry and immunological markers was observed in 7 out of the 9 cases. In three cases a noteworthy percentage of J 5+ cells was detected. The exceptional finding of lymphoid as well as megakaryocytic and myeloid transformations suggests that the target cell for these leukaemias could be a pluripotent stem cell.

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