It is anticipated that a substantial improvement in our understanding of MDS will come from the application of microarray analyses for gene expression profiling. By analogy with published results in other disorders, such as breast cancer, it is feasible that this technology will allow better classification, give a better prognostic guide and, importantly, give new insights into the biology of MDS. The study by Schoch and colleagues (2002) clearly shows that AML with reciprocal rearrangements can be distinguished by its specific gene expression profile. A minimum of 13 genes were able to separate AML subtypes with t(15;17), t(8;21) and inv(16).
The early studies of MDS illustrate the promise of this development. Miyazato et al. (2001) investigated gene expression profile in MDS and AML patients. This study identified 20
MDS-specific genes and 21 AML-specific genes and reported preferential expression of the DLK gene in MDS. Hofmann et al. (2002) studied the gene expression profile of 18 MDS patients compared with four controls. The study identified many genes expressed differentially between the low-risk and high-risk groups and between the high-risk or low-risk groups and the healthy control group. Class membership prediction was used to identify a subset of 11 predictor genes that could differentiate between patients with low-risk MDS, patients with high-risk MDS, and healthy controls.
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