Prognostic factors in chronic myelodysplastic syndromes: A multivariate analysis in 107 cases

Garcia, S. Gallach; Sanz, Miguel Á.; Amigó, Victoria; Colomina, Pedro; Carrera, Maria Dolores; Lorenzo, José Ignacio; Sanz, Guillermo

doi:10.1002/ajh.2830270303

Cited by 42 publications

(12 citation statements)

References 11 publications

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“…Dysplastic features were quantified using the score system devised by the Spanish Cooperative Group for the Study of Myelodysplastic Syndromes 16,17 as shown in Table 1. It assigns values depending on the grade of dyserythro-, dysgranulo-and dysthrombopoiesis.…”

Section: Morphological Studiesmentioning

confidence: 99%

Diagnosis of secondary myelodysplastic syndromes (MDS) following autologous transplantation should not be based only on morphological criteria used for diagnosis of de novo MDS

Amigo

Cañizo

Ríos

et al. 1999

Bone Marrow Transplant

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Summary:Secondary myelodysplastic syndromes (MDS) are increasingly being reported after autologous transplantation. Transient dysplastic changes have also been observed after this type of treatment. However, to the best of our knowledge no systematic morphological analysis has been perfomed to determine the influence of stem cell transplantation on bone marrow morphology. In 53 patients undergoing autologous transplantation, we evaluated the bone marrow, before and 6 and 12 months after the transplant, in order to analyze the appearance of dyshemopoietic changes, assessed according to a pre-established score. We also studied 25 bone marrow samples obtained at the time of diagnosis, prior to treatment, but we did not find morphological atypia. Six months after transplant, cellularity and thrombopoiesis had decreased in 38% and 49% of patients respectively, although 1 year after the process they were normal in most cases. Myelodysplasia was already present in bone marrow before transplantation and continued to be in evidence for a long time afterwards. This suggests that chemotherapy and radiotherapy used prior to transplantation are responsible for dysplastic changes. The myeloid line was the most affected with 100% of patients showing dysgranulopoiesis 1 year after autografting. Cytopenias were observed in 51% and 44% of patients 6 and 12 months after transplantation. Moreover, concomitant presence of cytopenia and myelodysplasia was observed in 37.7% of patients at 6 months after transplantation and 25% at 12 months, and therefore they could be diagnosed with MDS. These data contrast with the incidence of secondary MDS reported in earlier publications. According to these findings, the value of the FrenchAmerican-British Co-operative Group criteria for the diagnosis of MDS following autologous transplantation is questionable. Moreover, since dyshemopoietic features are almost always present after autologous transplant, morphological criteria are not useful for early

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Section: Morphological Studiesmentioning

confidence: 99%

Diagnosis of secondary myelodysplastic syndromes (MDS) following autologous transplantation should not be based only on morphological criteria used for diagnosis of de novo MDS

Amigo

Cañizo

Ríos

et al. 1999

Bone Marrow Transplant

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“…El síndrome hemorrágico fue el segundo en frecuencia de presentación en los pacientes con un 28%, igual al 28.3% que reporta Giralt (10) en su estudio, pero ligeramente superior al 24% encontrando por Fourcar (11) y al 20% de Sanz (9). En cuanto al síndrome infeccioso lo encontramos en un 17% de los pacientes, porcentaje que está entre 10 a 20% descrito en la literatura (10,12).…”

Section: Discusionunclassified

“…Encontramos 8 pacientes con AR, dos con ARSA, tres con AREB, uno con LMMC y cuatro con AREBt. Varios estudios han demostrado relación entre la variedad y el tiempo de sobreviva (9,12,25,26), teniendo mejor pronóstico ARSA luego AR, LMMC y con el peor pronóstico AREBt. Nosotros no hemos podido calcular el tiempo de sobrevida separadamente para cada variedad debido al pequeño número de casos estudiados.…”

Section: Discusionunclassified

Síndromes mieolodisplásicos.

Ulloa¹

2013

Rev Med Hered

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SUMMARYEigtheen patients with Myelodysplastic Syndrome were studied between Jan 84 to Dec 90 at the Hospital Nacional Cayetano Heredia. Ten patients were female and eight were males. The average age was 61.1 years. Sixty one had pancytopenia all patients presented anemia; 83% thrombocytopenia and 65% neutropenia. Bone marrow study showed hyper or normocelularities; 85% of the patients had diseritropiesis and 89% presented dismegacariopoiesis (micromegacariocities). According with FAB classification 44% had refractary anemia, (RA) 11% anemia with ring sidroblasts (RARS), 16.7% refractary anemia with blast in excess (RABE), 22.2% refractary anemia with blast in excess on transformation (RABE t) and 5.5% was diagnosed like chronic myelomonocitic leukemia (CMML). Five patients (27.8%) changed to another variety, four of these patients (22.2%) shifted to acute myeloid leukemia (AML). One patient with abnormal localization of precursors on bone marrow biopsy shifted to AML. The more frecuent complications were infections (45.8%), 16.6% of the patients had bleeding in the central nervous system. The mean survival time the diagnostic was 9.2 months. (Rev Med Hered 1993, 4:12-19) KEY WORDS: Myelodysplastic sindrome, pancytopenia, refractary anemia, anemia, neutropenia, thrombocytopenia. RESUMENEstudiamos retrospectivamente a 18 pacientes con síndrome mielodisplásico (SMD) en un período de 7 años (Enero de 1984 y Diciembre de 1990) en el Hospital Nacional Cayetano Heredia. Diez fueron mujeres y ocho, varones, la edad promedio fue de 61.1 años, El 61% presentó pancitopenia; todos presentaron anemia, 83% trombocitopenia y el 65% neutropenia. Las médulas óseas fueron hiper o normocelulares; 95% de los pacientes presentó diseritropoiesis y el 89% presentó dismegacariopoiesis micromegacarocitos. De acuerdo a la clasificación FAB 44% presentó anemia refractaria (AR), 11% anemia refractaria con sideroblastos en anillos (ARSA), 16.7% anemia refractaria con exceso de blastos (AREB), 22.2% con anemia refractaria con exceso de blastos en transformación

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“…Our criteria for grading dyshaemopoiesis were previously published elsewhere (Garcia et al, 1988). Dysplasia of megakaryopoiesis was present in 40 patients (mild in 30: marked in 10) and dysgranulopoiesis in 29 patients (mild in 23; marked in six).…”

mentioning

confidence: 99%

“…The analysis by Sanz et a1 (see accompanying letter) draws on patients that were prediagnosed as clear myelodysplastic syndromes and as such entered in a large study of MDS. The criteria employed for grading dyshaemopoiesis (Garcia et al, 1988) recognize mild dyserythropoiesis if abnormalities are found in > 50% of erythroblasts. This, however, does not cover the full range of AISA, because patients with > 15% ring sideroblasts but < 50% dysplastic red cell precursors would not fulfil their entry criteria.…”

mentioning

confidence: 99%