title: Presence of peripheral blasts in refractory anemia and refractory cytopenia with multilineage dysplasia predicts an unfavourable outcome.
abstract: The World Health Organization (WHO) assigns myelodysplastic syndrome (MDS) to RA/RCMD/RARS/RSCM/5q- syndrome, if medullary blasts are <5% and peripheral blast (PB) count < or =1%. In 1103 patients with these diagnoses, we analysed survival and risk of AML evolution depending on the presence of PB. Median survival in the group with 1% PB (n=74) was significantly lower as compared to those without PB (20 versus 47 months, p<0.00005). Cumulative risk of AML was significantly higher in patients showing PB (p<0.00005). Median survival of patients with PB was not different from that of RAEB I. We therefore propose to consider patients with PB, regardless of medullary blast, as RAEB I.
authors.affiliation: Department of Haematology, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 44, 1011 Lausanne, Switzerland. sabine.knipp@chuv.ch
authors.forename: Sabine
authors.initials: S
authors.lastname: Knipp
authors.forename: Corinna
authors.initials: C
authors.lastname: Strupp
authors.forename: Norbert
authors.initials: N
authors.lastname: Gattermann
authors.forename: Barbara
authors.initials: B
authors.lastname: Hildebrandt
authors.forename: Marc
authors.initials: M
authors.lastname: Schapira
authors.forename: Aristoteles
authors.initials: A
authors.lastname: Giagounidis
authors.forename: Carlo
authors.initials: C
authors.lastname: Aul
authors.forename: Rainer
authors.initials: R
authors.lastname: Haas
authors.forename: Ulrich
authors.initials: U
authors.lastname: Germing
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000753:Anemia, Refractory / Q000235:genetics / Q000473:pathology*; D000754:Anemia, Refractory, with Excess of Blasts / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D000756:Anemia, Sideroblastic / Q000473:pathology; D002869:Chromosome Aberrations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000235:genetics / Q000401:mortality*; D010198:Pancytopenia / Q000401:mortality; D011379:Prognosis; D012306:Risk; D015996:Survival Rate