title: Standards and impact of hematopathology in myelodysplastic syndromes (MDS).
abstract: The diagnosis, classification, and prognostication of patients with myelodysplastic syndromes (MDS) are usually based on clinical parameters, analysis of peripheral blood and bone marrow smears, and cytogenetic determinants. However, a thorough histologic and immunohistochemical examination of the bone marrow is often required for a final diagnosis and exact classification in these patients. Notably, histology and immunohistology may reveal dysplasia in megakaryocytes or other bone marrow lineages and/or the presence of clusters of CD34-positive precursor cells. In other cases, histology may reveal an unrelated or co-existing hematopoietic neoplasm, or may support the conclusion the patient is suffering from acute myeloid leukemia rather than MDS. Moreover, histologic investigations and immunohistology may reveal an increase in tryptase-positive cells, a coexisting systemic mastocytosis, or bone marrow fibrosis, which is of prognostic significance. To discuss diagnostic algorithms, terminologies, parameters, and specific issues in the hematopathologic evaluation of MDS, a Working Conference involving a consortium of US and EU experts, was organized in June 2010. The outcomes of the conference and resulting recommendations provided by the faculty, are reported in this article. These guidelines should assist in the diagnosis, classification, and prognostication in MDS in daily practice as well as in clinical trials.
authors.affiliation: Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Austria.|Ludwig Boltzmann Cluster Oncology, Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Valent
authors.affiliation: New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA.
authors.forename: Attilio
authors.initials: A
authors.lastname: Orazi
authors.affiliation: Institute of Pathology, Hannover Medical School, Hannover, Germany.
authors.forename: Guntram
authors.initials: G
authors.lastname: Büsche
authors.affiliation: Department of Pathology, University of Freiburg, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Schmitt-Gräff
authors.affiliation: Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Tracy I
authors.initials: TI
authors.lastname: George
authors.affiliation: Institute of Pathology, University of Munich.
authors.forename: Karl
authors.initials: K
authors.lastname: Sotlar
authors.affiliation: Institute of Pathology, Medical University of Vienna.
authors.forename: Berthold
authors.initials: B
authors.lastname: Streubel
authors.affiliation: Institute of Pathology, Medical University of Graz, Austria.
authors.forename: Christine
authors.initials: C
authors.lastname: Beham-Schmid
authors.affiliation: Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Austria.
authors.forename: Sabine
authors.initials: S
authors.lastname: Cerny-Reiterer
authors.affiliation: First Department of Internal Medicine, Elisabethinen Hospital Linz, Austria.
authors.forename: Otto
authors.initials: O
authors.lastname: Krieger
authors.affiliation: VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Arjan
authors.initials: A
authors.lastname: van de Loosdrecht
authors.affiliation: MLL Munich Leukemia Laboratory, Munich, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kern
authors.affiliation: Division of Hematology, Department of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Kiyoyuki
authors.initials: K
authors.lastname: Ogata
authors.affiliation: Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Austria.|Department of Obstetrics and Gynaecology, Medical University of Vienna.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Wimazal
authors.affiliation: Institute of Pathology, Semmelweis University, Budapest, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Csomor
authors.affiliation: Department of Hematology, Semmelweis University, Budapest, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Várkonyi
authors.affiliation: Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Austria.
authors.forename: Wolfgang R
authors.initials: WR
authors.lastname: Sperr
authors.affiliation: Department of Pathology, University of Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Werner
authors.affiliation: Institute of Pathology, Hannover Medical School, Hannover, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Kreipe
authors.affiliation: Institute of Pathology, Ansbach, Germany.
authors.forename: Horny
authors.initials: H
authors.lastname: Hans-Peter
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood; D001854:Bone Marrow Cells / Q000473:pathology*; D019411:Clinical Laboratory Techniques / Q000592:standards*; D017408:Guidelines as Topic; D006403:Hematologic Tests / Q000592:standards; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods / Q000592:standards; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis; D012015:Reference Standards
chemical_list: D014408:Biomarkers, Tumor