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Monocyte function negatively correlated with blast count, monocyte count and IPSS-R, implying that MDS disease severity affects monocyte function ( The increased expression of MHC-class II (HLA-DR) observed in monocytes in MDS PB and BM ( Upregulation of CD40 by monocytes has been suggested to be important in the suppression of hematopoiesis in MDS ( The CD40-CD40L system has proved to be important in various autoimmune diseases, such as rheumatoid arthritis and inflammatory bowel diseases ( Remarkably, the ability to induce macrophages was compromised in MDS-derived monocytes ( Of note, most of the previously described studies have not distinguished between monocyte subsets

This direct contact may enhance local tissue effects beyond what systemic administration achieves

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