[Re-evaluation of classification of myelodysplastic syndromes with low percentage bone marrow blasts].
OBJECTIVE
To apply the WHO criteria and the minimal diagnostic criteria to the classification of myelodysplastic syndromes (MDS) with low percentage (< 0.050) bone marrow (BM) blasts.


METHODS
Two hundred and ten MDS patients with less than 0.050 BM blasts diagnosed between 1988 and 2005 according to FAB criteria were retrospectively reclassified with WHO criteria (2001) and minimal diagnostic criteria.


RESULTS
According to the WHO criteria, 5 patients were diagnosed as refractory anemia (RA), 7 as refractory anemia with ringed sideroblasts (RARS), 76 as refractory cytopenia with multilineage dysplasia (RCMD), 9 as RCMD-RS, 35 as MDS-unclassified (MDS-U), 3 as 5q - syndromes, and the rest 75 patients could not be classified suitably. Among the latter 75 patients 16 BM smears showed dysplasia in more than 2 cell lineage but only unilineage cytopenia in peripheral blood (PB). Nine of them were reclassified as RCMD after followed up for more than half a year. Forty-four BM smears showed erythroid dysplasia only, but bicytopenia or pancytopenia in PB. Twenty-seven of them were classified as RCMD after follow-up. Fifteen BM smears not showed dysplasia in any myeloid lineage were reclassified as MDS (5 patients), HS-MDS (5 patients) and idiopathic cytopenia of uncertain significance (ICUS) (5 patients) according to the MDS minimal diagnostic criteria.


CONCLUSIONS
According to WHO criteria (2001), RA is the least diagnosis in MDS. The minimal diagnostic criteria for MDS classification of patients not fulfilled the standard criteria of MDS.
Yu
Ming-Hua
MH
Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Experimental Hematology, Tianjin 300020, China.
Xu
Ze-Feng
ZF
Li
Lin
L
Nie
Ling
L
Liu
Liang
L
Zhang
Yue
Y
Qin
Tie-Jun
TJ
Hao
Yu-Shu
YS
Xiao
Zhi-Jian
ZJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000753:Anemia, Refractory / Q000209:etiology; D001853:Bone Marrow / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult