The clinical picture of anemia with erythroid hyperplasia of the bone marrow, but without excessive hemolysis, has been a puzzle to hematologists for many years. In 1907, Luzzatto described one of the first cases as “pseudoaplastic anemia” [70]. However, it was only in 1941 that this syndrome became generally accepted with the description of 100 cases by Bomford and Rhodes [18]. Originally, cases with folic acid deficiency were included in this “refractory anemia” group. However, with the discovery of folic acid in the late 1940s a clear separation could be made between folic acid deficient myelodysplastic states and refractory anemia. As early as 1953, Block et al. recognized that patients with refractory anemia may develop leukemia [16]. He coined the term “preleukemia” in his report on 12 patients, 11 of whom showed features of refractory anemia.

Key words

Myelodysplastic syndromes leukemia smouldering leukemia chromosomal abnormalities bone marrow histology bone marrow culture myelofibrosis hemochromatosis bone marrow transplantation differentiating agents secondary leukemia leukemogenesis. 


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  1. 1.
    Abkowitz JL, Fialkow PJ, Niebruge DJ, Raskind WH, Adamson JW (1984) Pancytopenia as a clonal disorder of a multi-potent haemopoietic stem cell. J Clin Invest 73:258–261PubMedGoogle Scholar
  2. 2.
    Aisen P (1982) Current concepts in iron metabolism. Clin Haematol 11:241–257PubMedGoogle Scholar
  3. 3.
    Appelbaum FR, Storb R, Ramberg RE, Shulman HM, Buckner CD, Clift RA, Deeg HJ, Fefer A, Sanders J, Stewart P, Sullivan K, Witherspoon R, Thomas ED (1984) Allogeneic marrow transplantation in the treatment of preleukemia. Ann Intern Med 100:689–693PubMedGoogle Scholar
  4. 4.
    Barton JC, Conrad ME, Parmley RT (1980) Acute lymphoblastic leukemia in idiopathic refractory sideroblastic anemia:evidence for a common lymphoid and myeloid progenitor cell. Am J Hematol 9:109–115PubMedGoogle Scholar
  5. 5.
    Bauer F, Miescher PA (1982) Anémie réfractaire réversible dans un cas de thyréotoxicose. Schweiz Med Wochenschr 112:488–491PubMedGoogle Scholar
  6. 6.
    Bendix-Hansen K, Kerndrup G (1985) Myeloperoxidase-deficient polymorphonuclear leucocytes. V. Relation to neutrophil alkaline phosphatase activity and FAB-classification in the primary myelodysplastic syndrome. Scand J Haematol 35:197–200PubMedGoogle Scholar
  7. 7.
    Bennett JM, Catovsky D, Daniel MT,Fiandrin G,Galton DAG, Gralnick HR, Sultan C (1976) Proposals for the classification of the acute leukaemias. Br J Haematol 33:451–458PubMedGoogle Scholar
  8. 8.
    Bennett J, Catovsky D, Flandrin G, Galton D, Gralnick H, Sultan C (1982) FAB Cooperative Group:proposals for the classification of the myelodysplastic syndromes. Br J Haematol 51:189–199PubMedGoogle Scholar
  9. 9.
    Bergsagel DE, Bailey AJ, Langley GR (1979) The chemotherapy of plasma-cell myeloma and the incidence of acute leukemia. N Engl J Med 301:745–748Google Scholar
  10. 10.
    Beris P, Vetsch W, Cabrol C, Miescher PA (1981) Prognostic value of leuko- and/or thrombocytopenia in patients with PASA. International Society of Haematology, European and African Division, 6th Meeting Abstracts, Athens, p 120Google Scholar
  11. 11.
    Beris P, Favrod-Coune C, Miescher PA (1983) Association d’hénachromatose liée à l’HLA avec anémic réfractaire primaire acquise. Schweiz Med Wochenschr 113:1486Google Scholar
  12. 12.
    Beris P, Graf J, Miescher PA (1983) Primary acquired sideroblastic and primary acquired refractory anemia. Semin Hematol 20:101–113PubMedGoogle Scholar
  13. 13.
    Beris P, Rieder A, Andrey C, Helg C, Chapuis B (1984) Cytosine-arabinoside ( ARA-C) à dose réduite pour le traitement des leucémies myéloides aiguës. Schweiz Med Wochenschr 114:1763–1766PubMedGoogle Scholar
  14. 14.
    Berneman ZN, van Bockstaele D, de Meyer P, van der Planken M, Vertessen F, de Bock R, Peetermans ME (1985) A myelodysplastic syndrome preceding acute lymphoblastic leukaemia. Br J Haematol 60:353–354PubMedGoogle Scholar
  15. 15.
    Björkman SE (1956) Chronic refractory anemia with sideroblastic bone marrow:a study of four cases. Blood 11:250–259PubMedGoogle Scholar
  16. 16.
    Block M, Jaeobson LO, Bethard WF (1953) Preleukemic acute leukemia. JAMA 152:1018–1023Google Scholar
  17. 17.
    Boiron M (1985) Les leucémies secondaires. Actuality hénatologiques 19:39–47Google Scholar
  18. 18.
    Bomford RR, Rhodes CP (1941) Refractory anaemia. I. Clinical and pathological aspects. II. Aetiology and treatment. QJ Med 10:175–281Google Scholar
  19. 19.
    Bonati A, Delia D, Starcich R (1986) Progression of a myelodysplastic syndrome to pre-B acute lymphoblastic leukaemia with unusual phenotype. Br J Haematol 64:487–491PubMedGoogle Scholar
  20. 20.
    Boogaerts MA, Nelissen V, Roelant C, Goosens W (1983) Blood neutrophil function in primary myelodysplastic syndromes. Br J Haematol 55:217–227PubMedGoogle Scholar
  21. 21.
    Bottomley SS (1980) Sideroblastic anaemia. In:Jacobs A, Worwood M (eds) Iron in biochemistry and medicine II. Academic, LondonGoogle Scholar
  22. 22.
    Bottomley SL (1982) Sideroblastic anaemia. Clin Haematol 11:389–409PubMedGoogle Scholar
  23. 23.
    Breitman TR, Selonick SE, Collins SJ (1980) Induction of differentiation of the human promyelocytic leukemia cell line (HL60) by retinoic acid. Proc Natl Acad Sci USA 77:2936–2940PubMedGoogle Scholar
  24. 24.
    Brusamolino E, Pagnucco G, Bernasconi C (1986) Acute leukemia occurring in a primary neoplasia (secondary leukemia). A review on biological, epidemiological and clinical aspects. Haematologica 71:60–83PubMedGoogle Scholar
  25. 25.
    Buzaid AC, Garewal HS, Greenberg BR (1986) Management of myelodysplastic syndromes. Am J Med 80:1149–1157PubMedGoogle Scholar
  26. 26.
    Camba L, Joyner MV (1985) Refractory anaemia terminating in a combined lymphoproliferative and myeloproliferative disorder. J Clin Pathol 38:297–300PubMedGoogle Scholar
  27. 27.
    Carbonell F, Heimpel H, Kubanek B, Fliedner TM (1985) Growth and cytogenetic characteristics of bone marrow colonies from patients with 5q- syndrome. Blood 66:463–465PubMedGoogle Scholar
  28. 28.
    Cartwright GE, Edwards CQ, Skolnick MH (1980) Association of HLA-linked hemochromatosis with idiopathic refractory sideroblastic anemia. J Clin Invest 65:989–992PubMedGoogle Scholar
  29. 29.
    Cazzola M, Riccardi A (1986) Myelodysplastic syndromes:biologic and clinical aspects. Haematologica 71:147–159PubMedGoogle Scholar
  30. 30.
    Chui DHK, Clarke BJ (1982) Abnormal erythroid progenitor cells in human preleukemia. Blood 60:362–367PubMedGoogle Scholar
  31. 31.
    Clark R, Peters S, Hoy T, Smith S, Whittaker K, Jacobs A (1986) Prognostic importance of hypodiploid hemopoietic precursors in myelodysplastic syndromes. N Engl J Med 314:1472–1475PubMedGoogle Scholar
  32. 32.
    Coiffier B, Adeline P, Vialla JJ, Bryan PA, Fiere D, Gentilhomme O, Vuvan H (1983) Dysmyelopoietic syndromes. A search for prognostic factors in 193 patients. Cancer 52:83–90PubMedGoogle Scholar
  33. 33.
    Coleman CN, Burke JS, Varghese A et al. (1982) Secondary leukemia and non-Hodgkin’s lymphoma in patients treated for Hodgkin’s disease. In:Kaplan HS, Rosenberg SA (eds) Malignant lymphomas:etiology, immunology, pathology, treatment, vol 3. Academic, Orlando, p 259Google Scholar
  34. 34.
    Copplestone JA, Mufti GJ, Hamblin TJ, Oscier DG (1986) Immunological abnormalities in myelodysplastic syndromes. II. Coexistent lymphoid or plasma cell neoplasms:a report of 20 cases unrelated to chemotherapy. Br J Haematol 63:149–159PubMedGoogle Scholar
  35. 35.
    Cronkite EP (1987) Chemical leukemogenesis:benzene as a model. Semin Hematol 24:2–11PubMedGoogle Scholar
  36. 36.
    Crosby WH (1957) Siderocytes and the spleen. Blood 12:165–170PubMedGoogle Scholar
  37. 37.
    Dacie JV, Smith MD, White JC, Mollin DL (1959) Refractory normoblastic anaemia:a clinical and haematological study of 7 cases. Br J Haematol 5:56–82PubMedGoogle Scholar
  38. 38.
    de Gramont A, Louvet C, Smadja N, Krulik M, Brissaud P, Debray J (1985) Leucémies secondaires:signification des anomalies hématologiques survenant pendant ou après le traitement d’un premier cancer. A propos de 111 observations. In:Les risques de la radiothérapie et de la chimiothérapie en cancérologie. Masson, Paris, pp 59–62Google Scholar
  39. 39.
    de Gramont A, Rioux E, Drolet Y, Delage JM (1985) Erythrocyte mean corpuscular volume during cytotoxic therapy and the risk of secondary leukemia. Cancer 55:493–495PubMedGoogle Scholar
  40. 40.
    Desforges JF (1983)Cytarabine:low dose, high dose, no dose? N Engl J Med 309:1637–1639PubMedGoogle Scholar
  41. 41.
    Eridani S, Chan LC, Halil’O, Pearson TC (1985) Acute biphenotypic leukaemia (myeloid and null-ALL type) supervening in a myelodysplastic syndrome. Br J Haematol 61:525–529PubMedGoogle Scholar
  42. 42.
    Faille A, Dresch C, Poirier O, Balitrand N, Najean Y (1978) Prognostic value of in vitro bone marrow culture in refractory anaemia with excess of myeloblasts. Scand J Haematol 20:280–286PubMedGoogle Scholar
  43. 43.
    Francis GE, Miller EJ, Wonke B, Wing MA, Berney JJ, Hoffbrand AV (1983) Use of bone-marrow culture in prediction of acute leukaemic transformation in preleukaemia. Lancet I:1409–1412Google Scholar
  44. 44.
    Goldberg A (1972) Lead poisoning and haem biosynthesis. Br J Haematol 23:521–524PubMedGoogle Scholar
  45. 45.
    Grasso JA, Myers TJ, Hines JD, Sullivan AL (1980) Energy-dispersive X-ray analysis of the mitochondria of sideroblastic anaemia. Br J Haematol 46:57–72PubMedGoogle Scholar
  46. 46.
    Greenberg PL, Nichols WC, Schrier SL (1971) Granulopoiesis in acute myeloid leukemia and preleukemia. N Engl J Med 284:1225–1230PubMedGoogle Scholar
  47. 47.
    Greenberg PL, Mara B (1979) The preleukemic syndrome, correlation of in vitro parameters of granulopoiesis with clinical features. Am J Med 66:951–95 8Google Scholar
  48. 48.
    Greenberg PL (1980) Clinical relevance of in vitro study of granulocytopoiesis. Scand J Haematol 25:369–381PubMedGoogle Scholar
  49. 49.
    Greenberg PL (1983) The smoldering myeloid leukemic states:clinical and biologic features. Blood 61:1035–1044PubMedGoogle Scholar
  50. 50.
    Greene MH, Boice JD, Greer BE, Blessing JA, Dembo AJ (1982) Acute non-lymphocytic leukemia after therapy with alkylating agents for ovarian cancer. N Engl J Med 307:1416–1421PubMedGoogle Scholar
  51. 51.
    Griffin JD, Spriggs D, Wisch S, Kufe DW (1985) Treatment of preleukemic syndromes with continuous intravenous infusion of low-dose cytosine arabinoside. J Clin Oncol 3:982–991PubMedGoogle Scholar
  52. 52.
    Hehlmann R, Zonnchen BN, Thiel E, Wasther B (1983) Idiopathic refractory sideroacrestic anemia ( IRSA) progressing to acute mixed lymphoblastic myelomonoblastic leukemia. Blut 46:11–21PubMedGoogle Scholar
  53. 53.
    Hokland P, Kerndrup G, Griffin JD, Ellegaard J (1986) Analysis of leukocyte differentiation antigens in blood and bone marrow from preleukemia (refractory anemia) patients using monoclonal antibodies. Blood 67:898–902PubMedGoogle Scholar
  54. 54.
    Ishikura H, Sawada H, Okazaki T, Mochizuki T, Izumi Y, Yamagishi M, Uchino H (1984) The effect of low dose Ara-C in acute non-lymphoblastic leukaemias and atypical leukaemia. Br J Haematol 58:9–18PubMedGoogle Scholar
  55. 55.
    Izumi Y, Sawada H, Okazaki T, Mochizuki T, Ishikura H, Tashima M, Yamagishi M, Uchino H (1985) Favourable remission rate by repeating low dose ARA-C treatment in ANLL and RAEB. Br J Haematol 61:187–190PubMedGoogle Scholar
  56. 56.
    Jacobs A (1985) Myelodysplastic syndromes:pathogenesis, functional abnormalities and clinical implications. J Clin Pathol 38:1201–1217PubMedGoogle Scholar
  57. 57.
    Jacobs A (1986) Annotation. Primary acquired sideroblastic anaemia. Br J Haematol 64:415–418PubMedGoogle Scholar
  58. 58.
    Jacobs RH,Cornbleet MA, Vandiman JW, Larson RA, Le Bean MM, Rowley JD (1986) Prognostic implications of morphology and karyotype in primary myelodysplastic syndromes. Blood 67:1765–1772PubMedGoogle Scholar
  59. 59.
    Jacot-des Combes E, Beris P, Kapanci Y (1985) Plastic embedded bone marrow biopsy in the evaluation of myelodysplastic syndromes. Pathol Res Pract 180:280Google Scholar
  60. 60.
    Juvonen E, Partanen S, Knuutila S, Ruutu T (1986) Megakaryocyte colony formation by bone marrow progenitors in myelodysplastic syndromes. Br J Haematol 63:331–334PubMedGoogle Scholar
  61. 61.
    Knapp RH, Dewald GW, Pierre RV (1985) Cytogenetic studies in 174 consecutive patients with preleukemic or myelodysplastic syndromes. Mayo Clin Proc 60:507–516PubMedGoogle Scholar
  62. 62.
    Koeffler HP, Cline MJ, Golde DW (1978) Erythropoiesis in preleukemia. Blood 51:1013–1019PubMedGoogle Scholar
  63. 63.
    Koeffler HP, Rowley J (1985) Therapy–related leukemia. In:Wiernik PH, Canellos G, Kyle RA et al. (eds) Neoplastic disease of the blood, vol 1. Churchill Livingstone, New York, pp 357–381Google Scholar
  64. 64.
    Koeffler HP (1986) Myelodysplastic syndromes (preleukemia). Semin Hematol 23:284–299PubMedGoogle Scholar
  65. 65.
    Kuriyama K, Tomonaga M, Matsuo T, Ginnai I, Ichimaru M (1986) Diagnostic significance of detecting pseudo-Pelger-Huët anomalies and micromegakaryocytes in myelodysplastic syndrome. Br J Haematol 63:665–669PubMedGoogle Scholar
  66. 66.
    Larson RA (1985) Management of myelodysplastic syndromes. Ann Intern Med 103:136–138PubMedGoogle Scholar
  67. 67.
    Lewis SM, Verwilghen RL (1972) Dyserythropoiesis and dyserythropoietic anemia. Br J Haematol 23:1–4PubMedGoogle Scholar
  68. 68.
    Ley TJ, Griffith P, Nienhuis AW (1982) Transfusion haemosiderosis and chelation therapy. Clin Haematol 11:437–464PubMedGoogle Scholar
  69. 69.
    Lotem J, Sachs L (1974) Different blocks in the differentiation of myeloid leukemic cells. Proc Natl Acad Sci USA 71:3507–3511PubMedGoogle Scholar
  70. 70.
    Luzzatto AM (1907) Sull anemia grave megaloblastica sensa reporto ematologica correspondente (anemia pseudo-aplastica). Riv Ven 47:193–197Google Scholar
  71. 71.
    Malpass TW, Savage B, Hanson SR, Slichter SJ, Harker LA (1984) Correlation between prolonged bleeding time and depletion of platelet dense granule ADP in patients with myelodysplastic and myeloproliferative disorders. J Lab Clin Med 103:894–904PubMedGoogle Scholar
  72. 72.
    May A, de Souza P, Barnes K, Kaaba S, Jacobs A (1982) Erythroblast iron metabolism in sideroblastic marrows. Br J Haematol 52:611–621PubMedGoogle Scholar
  73. 73.
    Michels S, McKenna R, Arthur D (1985) Therapy-related acute myeloid leukemia and myelodysplastic syndrome:a clinical and morphologic study of 65 cases. Blood 65:1364–1372PubMedGoogle Scholar
  74. 74.
    Michiels JS, Mallios-Zorbala H, Prins MEF, Hählen K, Hagemeijer A (1986) Simple monosomy 7 and myelodysplastic syndrome in thirteen patients without previous cytostatic treatment. Br J Haematol 64:425–433PubMedGoogle Scholar
  75. 75.
    Miescher PA, Farquet JJ (1974) Chronic myelomonocytic leukemia in adults. Semin Hematol 11:129–139PubMedGoogle Scholar
  76. 76.
    Milner GR, Testa NG, Geary CG, Dexter TM, Muldal S, Maclver JE, Lajtha LG (1977) Bone marrow culture studies in refractory cytopenia and smouldering leukaemia. Br J Haematol 35:251–261PubMedGoogle Scholar
  77. 77.
    Mitelman F, Brandt L, Nilsson P (1979) Relation among occupational exposure to potential mutagenic/carcinogenic agents, clinical findings, and bone marrow chromosomes in acute nonlymphocytic leukemia. Blood 52:1229–1237Google Scholar
  78. 78.
    Moir DJ, Jones PAE, Pearson J, Duncan JR, Cook P, Buckle VJ (1984) A new translocation t(1;3) (p36;q21) in myelodysplastic disorders. Blood 64:553–555PubMedGoogle Scholar
  79. 79.
    Moloney WC, Rosenthal DS (1981) Treatment of early acute nonlymphocytic leukemia with low dose cytosine arabinoside. Haematol Blood Transf 26:59–62Google Scholar
  80. 80.
    Mufti GJ, Oscier DG, Hamblin TJ, Bell AJ (1983) Low doses of cytarabine in the treatment of myelodysplastic syndrome and acute leukemia. N Engl J Med 309:1653–1654PubMedGoogle Scholar
  81. 81.
    Mufti GJ, Stevens JR, Oscier DG, Hamblin TJ, Machin D (1985) Myelodysplastic syndromes:a scoring system with prognostic significance. Br J Haematol 59:425–433PubMedGoogle Scholar
  82. 82.
    Mufti GJ (1986) Proposed trial of low dose cytosine arabinoside with and without 13-cis retinoid acid versus supportive care only, in myelodysplastic syndromes. King’s College School of Medicine (national coordinating trial)Google Scholar
  83. 83.
    Mufti GJ, Figes A, Hamblin TJ, Oscier DG, Coplestone J A (1986) Immunological abnormalities in myelodysplastic syndromes. I. Serum immunoglobulins and autoantibodies. Br J Haematol 63:143–147PubMedGoogle Scholar
  84. 84.
    Pedersen-Bjergaard J, Larsen SO (1982) Incidence of acute nonlymphocytic leukemia, pre-leukemia and acute myeloproliferative syndrome up to 10 years after treatment of Hodgkin’s disease. N Engl J Med 307:965–971PubMedGoogle Scholar
  85. 85.
    Pesce A, Cassuto JP, Bayle J, Raynaud S, Fuzibet JG, Gratecos N, Dujardin P (1986) Very-low-dose cytarabine for elderly patients. Lancet I:1456Google Scholar
  86. 86.
    Peters SW, Clark RE, Hoy TG, Jacobs A (1986) DNA content and cell cycle analysis of bone marrow cells in myelodysplastic syndromes ( MDS ). Br J Haematol 62:239–245PubMedGoogle Scholar
  87. 87.
    Picozzi VJ,Swanson GF, Morgan R, Hecht F, Greenberg PL (1986) 13-cis retinoic acid treatment for myelodysplastic syndromes. J Clin Oncol 4:589–595PubMedGoogle Scholar
  88. 88.
    Poirier O, Chomienne C, Castaigne S, Degos L, Abita JP, Najean Y (1986) Pharmacokinetic data on very-low-dose cytarabine. Lancet I:1436–1457Google Scholar
  89. 89.
    Prchal JT, Throckmorton DW, Carrol AJ, Fuson EW, Gams RA, Prchal JS (1978) A common progenitor for human myeloid and lymphoid cells. Nature 274:590–591PubMedGoogle Scholar
  90. 90.
    Raskind WH, Tirumali N, Jacobson R, Singer J, Fialkow PJ (1984) Evidence for a multistep pathogenesis of a myelodysplastic syndrome. Blood 63:1318–1323PubMedGoogle Scholar
  91. 91.
    Rheingold JJ, Kaufman R, Adelson E, Lear A (1963) Smoldering acute leukemia. N Engl J Med 268:812–816PubMedGoogle Scholar
  92. 92.
    Rosenthal DS, Moloney WC (1984) Refractory dysmyelopoietic anemia and acute leukemia. Blood 63:314–318PubMedGoogle Scholar
  93. 93.
    Rowley RA, Young RJ, Smith AB (1981) Leukemia in benzene workers. Am J Ind Med 2:217–245Google Scholar
  94. 94.
    Russell NH, Keenan JP, Bellingham AF (1979) Thrombocytopathy in preleukaemia. Br J Haematol 41:417–425PubMedGoogle Scholar
  95. 95.
    Sandberg AA (1986) The chromosomes in human leukemia. Semin Hematol 23:201–217PubMedGoogle Scholar
  96. 96.
    Scott CS, Cahill A, Bynde AG, Ainley MJ, Hough D, Roberts BE (1983) Esterase cytochemistry in primary myelodysplastic syndromes and megaloblastic anaemias:demonstration of abnormal staining patterns associated with dysmyelopoiesis. Br J Haematol 55:411–418PubMedGoogle Scholar
  97. 97.
    Second International Workshop on Chromosomes in Leukemia (1981) Chromosomes in pre-leukemia. Cancer Genet Cytogenet 2:108–113Google Scholar
  98. 98.
    Solal-Celigny P, Desaint B, Herrera A, Chastang C, Amar M, Vroclans M, Brousse N, Mancilia F, Renoux M, Bernard J-F, Boivin P (1984) Chronic myelomonocytic leukemia according to FAB classification:analysis of 35 cases. Blood 63:634–638PubMedGoogle Scholar
  99. 99.
    Sultan C, Sigaux F, Imbert M, Reyes F (1981) Acute myelodysplasia with myelofibrosis:a report of eight cases. Br J Haematol 49:11–16PubMedGoogle Scholar
  100. 100.
    Swanson G, Picozzi V, Morgan R, Hecht F, Greenberg P (1986) Responses of hemopoietic precursors to 13-cis retinoic acid and 1,25 dihydroxy-vitamin D3 in the myelodysplastic syndromes. Blood 67:1154–1161PubMedGoogle Scholar
  101. 101.
    Anonymous (1984) Treatment for pre-leukemia? (editorial). Lancet I:943–944Google Scholar
  102. 102.
    Tricot G, de Wolf-Peeters C, Hendrickx B, Verwilghen RL (1984) Bone marrow histology in myelodysplastic syndromes. I. Histological findings in myelodysplastic syndromes and comparison with bone marrow smears. Br J Haematol 57:423–430PubMedGoogle Scholar
  103. 103.
    Tricot G, Vlietinck R, Boogaerts MA, Hendrickx B, de Wolf-Peeters C, van den Berghe H, Verwilghen RL (1985) Prognostic factors in the myelodysplastic syndromes:importance of initial data on peripheral blood counts, bone marrow cytology, trephine biopsy and chromosomal analysis. Br J Haematol 60:19–32PubMedGoogle Scholar
  104. 104.
    Tricot G, Boogaerts MA (1986) The role of aggressive chemotherapy in the treatment of the myelodysplastic syndromes. Br J Haematol 63:477–483PubMedGoogle Scholar
  105. 105.
    Tricot G, Mecucci C, van den Berghe H (1986) Annotation. Evolution of the myelodysplastic syndromes. Br J Haematol 63:609–614PubMedGoogle Scholar
  106. 106.
    Valentine WN, Konrad PN, Paglia DE (1973) Dyserythropoiesis, refractory anemia and “pre-leukemia”:metabolic features of the erythrocytes. Blood 41:857–875PubMedGoogle Scholar
  107. 107.
    Vallespi T, Torrabadella M, Julia A, Irriguible D, Jaen A, Acebedo G, Triginer J (1985) Myelodysplastic syndromes:a study of 101 cases according to FAB classification. Br J Haematol 61:83–92PubMedGoogle Scholar
  108. 108.
    Verma D, Spitzer G, Dicke K, McCredie K (1979) In vitro agar culture patterns in preleukemia and their clinical significance. Leukemia Ref 3:41–49Google Scholar
  109. 109.
    Vilter RW, Will JJ, Jarrold T (1967) Refractory anemia with hyperplastic bone marrow (aregenerative anemia). Semin Hematol 4:175–193PubMedGoogle Scholar
  110. 110.
    Weisdorf DJ, Oken MM, Johnson GJ, Rydell RE (1983) Chronic myelodysplastic syndrome:short survival with or without evolution to acute leukaemia. Br J Haematol 55:691–700PubMedGoogle Scholar
  111. 111.
    Winter JN, Variakojis D, Gaynor ER, Larson RA, Miller KB (1985) Low–dose cytosine arabinoside ( ARA-C) therapy in the myelodysplastic syndromes and acute leukemia. Cancer 56:443–449PubMedGoogle Scholar
  112. 112.
    Wisch JS, Griffin JD, Kufe DW (1983) Response of preleukemic syndromes to continuous infusion of low-dose cytarabine. N Engl J Med 309:1599–1602PubMedGoogle Scholar
  113. 113.
    Worsley A, Mufti GJ, Copplestone JA, Oscier DG, Hamblin TJ (1986) Very-low-dose cytarabine for myelodysplastic syndromes and acute myeloid leukaemia in the elderly. Lancet I:966Google Scholar
  114. 114.
    Yunis JJ (1986) Should refined chromosomal analysis be used routinely in acute leukemias and myelodysplastic syndrome? N Engl J Med 315:322–325PubMedGoogle Scholar
  115. 115.
    Yunis JJ, Rydell RE, Oken MM, Arnesen MA, Mayer MG, Lobell M (1986) Refined chromosome analysis as an independent prognostic indicator in de novo myelodysplastic syndromes. Blood 67:1721–1730PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • P. Beris
  • P. A. Miescher
    • 1
  1. 1.Division of HematologyGeneva University HospitalGeneva 4Switzerland

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