Multilineage dysplasia without increased blasts identifies a poor prognosis subset of myelodysplastic syndromes

Balduini, Carlo L.; Guarnone, Roberta; Pecci, Alessandro; Centenara, Esther; Ascari, E

doi:10.1038/sj.leu.2401165

Cited by 20 publications

(5 citation statements)

References 4 publications

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“…In contrast to patients with RA and only dyserythropoiesis, patients with multilineage dysplasia have bicytopenia or pancytopenia, a higher incidence of cytogenetic abnormalities, more frequent progression to AML, and shorter survival. [66][67][68][69] In the WHO classification, RA and RARS are defined as diseases in which dysplasia is morphologically restricted to the erythroid lineage (Table 2). If there is multilineage dysplasia-that is, 10% or more dysplastic cells in 2 or more of the myeloid lineages-and fewer than 5% blasts, no Auer rods, and no monocytosis, the diagnosis is RCMD.…”

Section: The Who Classification Refines the Definition Of Ra And Rarsmentioning

confidence: 99%

The World Health Organization (WHO) classification of the myeloid neoplasms

Vardiman

Harris²,

Brunning³

2002

Blood

1,914

1,288

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A World Health Organization (WHO) classification of hematopoietic and lymphoid neoplasms has recently been published. This classification was developed through the collaborative efforts of the Society for Hematopathology, the European Association of Hematopathologists, and more than 100 clinical hematologists and scientists who are internationally recognized for their expertise in hematopoietic neoplasms. For the lymphoid neoplasms, this classification provides a refinement of the entities described in the Revised European-American Lymphoma (REAL) Classification-a system that is now used worldwide. To date, however, there has been no published explanation or rationale given for the WHO classification of the myeloid neoplasms. The purpose of this communication is to outline briefly the WHO classification of malignant myeloid diseases, to draw attention to major differences between it and antecedent classification schemes, and to provide the rationale for those differences. ( IntroductionRecently, the World Health Organization (WHO), in conjunction with the Society for Hematopathology and the European Association of Hematopathology, published a new classification for hematopoietic and lymphoid neoplasms. 1 The concepts that underlie this classification were derived from numerous published clinical and scientific studies and from the experience of more than 100 pathologists, clinicians, and scientists from around the world who collaborated to develop this consensus classification. 2 A basic principle of the WHO system is that the classification of hematopoietic and lymphoid neoplasms should utilize not only morphologic findings but also all available information, including genetic, immunophenotypic, biologic, and clinical features to define specific disease entities. Essentially, the WHO classification attempts to incorporate those disease characteristics that have proved to have clinical and biologic relevance into a useful, working nomenclature.For the lymphoid neoplasms, the WHO classification provides refinement of the entities defined in the Revised EuropeanAmerican Lymphoma (REAL) Classification-a system that is now widely used by pathologists and clinicians. 3 The WHO classification of myeloid neoplasms includes many of the criteria of the French-American-British (FAB) Cooperative Group classifications of acute myeloid leukemia (AML) 4 and myelodysplastic syndromes (MDS) 5 as well as guidelines of the Polycythemia Vera Study Group (PVSG) for the chronic myeloproliferative diseases (CMPDs), 6,7 but there are some significant differences. The purpose of this communication is to outline briefly the WHO classification of the myeloid neoplasms, to draw attention to major differences between the WHO and previous classifications of these disorders, and to provide the rationale for these differences. In addition, we wish to address and clarify specific issues concerning the classification that have appeared both prior and subsequent to the publication of the WHO monograph. The WHO classification of the myeloid neop...

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Section: The Who Classification Refines the Definition Of Ra And Rarsmentioning

confidence: 99%

The World Health Organization (WHO) classification of the myeloid neoplasms

Vardiman

Harris²,

Brunning³

2002

Blood

1,914

1,288

View full text Add to dashboard Cite

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“…These criteria were adapted in the study of 1600 patients with MDS by Germing et al, 5 although they did elect to use a 40% threshold for megakaryocytes. Germing et al and others 8,9 have confirmed the worse prognosis of RCMD compared to RA or RARS. To accurately evaluate the WHO proposals it will be necessary to reassess the "unclassified" group in the Nösslinger et al study utilizing these criteria.…”

mentioning

confidence: 78%

Myelodysplastic syndromes: from French-American-British to World Health Organization: a commentary

Bennett

Brunning

Vardiman

2002

Blood

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“…This subcategory is an addition in the WHO classification of MDSs that was not recognized in the FAB system, and its identification has improved the prognostic usefulness of the morphologic classification of MDSs. [31][32][33][34][35][36][37][38] RCMD is characterized by 1 or more cytopenias in the peripheral blood and dysplastic changes in 2 or more of the myeloid lineages: erythroid, granulocytic, and/or megakaryocytic. There are fewer than 1% blasts in the blood and fewer than 5% in the bone marrow.…”

Section: Refractory Cytopenia With Multilineage Dysplasiamentioning

confidence: 99%

Myelodysplastic syndromes

Zhou

Orazi

Czader

2011

Seminars in Diagnostic Pathology

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Myelodysplastic syndromes (MDS) are hematopoietic neoplasms characterized by an ineffective hematopoiesis associated with cytopenia(s), functional abnormalities of bone marrow lineages, morphologic dysplasia, and a progression to acute myeloid leukemia. The pathogenesis of MDS is exceedingly complex and involves the hematopoietic stem cells/hematopoietic precursors, bone marrow microenvironment, and complex interaction between these components. The diagnostic strategy in MDS has evolved significantly over the years from a strategy based almost exclusively on peripheral blood smear and bone marrow aspirate morphology to the integrated approach used in the 2001 and 2008 World Health Organization (WHO) classification schemes. In parallel with the diagnostic approach, evolution has occurred in the prognostic assessment and evaluation of treatment response. The prognostic assessment now includes both disease-related factors and patient-specific characteristics such as nonhematologic comorbidities. All these developments are particularly important considering the ever-increasing treatment options available for MDS. This review focuses on the diagnostic approach to MDS and highlights recent developments in the pathogenesis as well as select clinical advances. We present the overview of the minimal diagnostic criteria for a diagnosis of MDS, the WHO classification scheme, and briefly address the risk stratification.

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Multilineage dysplasia without increased blasts identifies a poor prognosis subset of myelodysplastic syndromes

Cited by 20 publications

References 4 publications

The World Health Organization (WHO) classification of the myeloid neoplasms

The World Health Organization (WHO) classification of the myeloid neoplasms

Myelodysplastic syndromes: from French-American-British to World Health Organization: a commentary

Myelodysplastic syndromes

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