Research

Pathology & Oncology Research

, Volume 18, Issue 3, pp 681-690

First online:

Angiogenesis and Survival in Patients with Myelodysplastic Syndrome

  • Aleksandar SavicAffiliated withClinic of Hematology, Clinical Center of Vojvodina, Faculty of Medicine Email author 
  • , Vesna Cemerikic-MartinovicAffiliated withPathohistology Laboratory Beolab
  • , Sinisa DovatAffiliated withCollege of Medicine, Milton S. Hershey Medical Center, Children’s Hospital, Department of Pediatrics, H085, Division of Pediatric Hematology/Oncology, Pennsylvania State University
  • , Nebojsa RajicAffiliated withClinic of Hematology, Clinical Center of Vojvodina, Faculty of Medicine
  • , Ivana UrosevicAffiliated withClinic of Hematology, Clinical Center of Vojvodina, Faculty of Medicine
  • , Borivoj SekulicAffiliated withClinic of Hematology, Clinical Center of Vojvodina, Faculty of Medicine
  • , Vanja KvrgicAffiliated withClinic of Hematology, Clinical Center of Vojvodina, Faculty of Medicine
  • , Stevan PopovicAffiliated withClinic of Hematology, Clinical Center of Vojvodina, Faculty of Medicine

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Abstract

Angiogenesis has been implicated in the pathogenesis and prognosis of myelodysplastic syndrome (MDS). In this study, we investigated the relationship between microvessel density (MVD), vascular endothelial growth factor (VEGF) expression, common morphological and clinical factors, and survival in patients with MDS. We examined the MVD of paraffin-embedded bone marrow sections from 70 MDS patients and 31 controls. VEGF expression was determined in 50 patients and 20 controls. The median MVD in MDS patients was significantly higher than that in controls (p = 0.025), whereas there was no difference in VEGF expression between MDS patients and controls. In univariate analysis, increased MVD was associated with a shorter survival time (p = 0.023). However, in multivariate analysis, MVD was not an independent predictor of survival. The VEGF expression did not influence survival in univariate analysis. Survival was independently influenced by platelet count (p = 0.0073), cytogenetic risk category (p = 0.022), and transfusion dependence (p = 0.0073). Neither MVD nor VEGF expression were predictors for progression to acute myeloid leukemia in univariate analysis. Progression to acute myeloid leukemia was independently influenced only by the cytogenetic risk category (p = 0.022). This study confirmed increased MVD in MDS. It does not support an independent prognostic role of angiogenesis in MDS.

Keywords

Myelodysplastic syndrome Angiogenesis Microvessel density VEGF Survival Prognosis