Patients with aplastic anemia and other autoimmune diseases such as rheumatoid arthritis are more likely to develop myelodyplasia when compared to healthy controls. Inflamed tissue from Barrett’s esophagus, areas of bronchitis, healing burn tissue, and bowel with ulcerative colitis commonly show increased numbers of tetraploid and aneuploid cells, suggesting that inflammation may have a role in promoting genomic instability. We recently demonstrated the common occurrence of aneuploid cells in the 15 buccal smears of transplant patients with graft versus host disease involving the oral mucosa but not in transplant patients without GVSH when these cells were examined by fluorescence in situ hybridization (FISH). Aneuploidy could be reproduced in 5 normal keratinocyte cultures following incubation with allogeneic HLA-mismatched lymphocytes. Oxidative stress and repeated cell division with telomere shortening may play a role in producing karyotypic abnormalities. Alternatively, in the AA bone marrow factors such as increased cytokine expression and the presence of cytotoxic T cells in marrow may lead to a relatively improved survival of cells with certain chromosomal abnormalities. In this respect, we previously demonstrated survival advantages for trisomy 8 and monosomy 7 relative to diploid cells (
Disclosures: No relevant conflicts of interest to declare.