Pathology & Oncology Research

, Volume 18, Issue 3, pp 681–690 | Cite as

Angiogenesis and Survival in Patients with Myelodysplastic Syndrome

  • Aleksandar Savic
  • Vesna Cemerikic-Martinovic
  • Sinisa Dovat
  • Nebojsa Rajic
  • Ivana Urosevic
  • Borivoj Sekulic
  • Vanja Kvrgic
  • Stevan Popovic
Research

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 

Abbreviations

ALIP

Atypical localization of immature progenitor cells

AML

Acute myeloid leukemia

AML-MRC

Acute myeloid leukemia with myelodysplasia-related changes

CMML

chronic myelomonocytic leukemia

FAB

French-American-British

H&E

hematoxylin and eosin

IPSS

International Prognostic Scoring System

MDS

Myelodysplastic syndrome

MVD

Microvessel density

RA

Refractory anemia

RAEB

Refractory anemia with excess blasts

RAEB-T

Refractory anemia with excess blasts in transformation

RARS

Refractory anemia with ringed sideroblasts

RCMD

Refractory cytopenia with multilineage dysplasia

RCUD

Refractory cytopenia with unilineage dysplasia

VEGF

Vascular endothelial growth factor

WHO

World Health Organization

WPSS

WHO classification-based prognostic scoring system

Notes

Acknowledgments

We wish to thank Dusan Pejin and Nada Vuckovic for their support.

Contributors: All authors have actively participated to the study and approved the manuscript. Aleksandar Savic designed the research, collected patient information, analyzed and interpreted the data, and wrote the manuscript. Vesna Cemerikic-Martinovic contributed control patients, reviewed bone marrow histology. Sinisa Dovat provided critical revisions. Borivoje Sekulic and Vanja Kvrgic collected patient information. Ivana Urosevic and Nebojsa Rajic collected patient information, and contributed patients. Stevan Popovic contributed patients.

Conflicts of interest statement

There are no conflicts of interests to disclose.

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Copyright information

© Arányi Lajos Foundation 2012

Authors and Affiliations

  • Aleksandar Savic
    • 1
  • Vesna Cemerikic-Martinovic
    • 2
  • Sinisa Dovat
    • 3
  • Nebojsa Rajic
    • 1
  • Ivana Urosevic
    • 1
  • Borivoj Sekulic
    • 1
  • Vanja Kvrgic
    • 1
  • Stevan Popovic
    • 1
  1. 1.Clinic of HematologyClinical Center of Vojvodina, Faculty of MedicineNovi SadSerbia
  2. 2.Pathohistology Laboratory BeolabBelgradeSerbia
  3. 3.College of Medicine, Milton S. Hershey Medical Center, Children’s Hospital, Department of Pediatrics, H085, Division of Pediatric Hematology/OncologyPennsylvania State UniversityHersheyUSA

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