title: Cellularity, characteristics of hematopoietic parameters and prognosis in myelodysplastic syndromes.
abstract: BACKGROUND
  Myelodysplastic syndromes (MDS) present with a normo- or hyperplastic bone marrow in most cases. We aimed at a characterization of patients with different types of cellularity.
  
  
  METHODS
  We assessed marrow cellularity both by histology and cytology in 1270 patients and analyzed hematologic, cytogenetic, and prognostic parameters accordingly.
  
  
  RESULTS
  The concordance of the assessment of cellularity differed dramatically between histology and cytology as only 36.5% were described as hypocellular by both methods (P < 0.0005) (hypocellular 16.4%, normocellular 23.3%, hypercellular 60.3%). There were no major differences with regard to hematopoietic insufficiency. The presence of fibrosis was associated to hypercellular bone marrow. Median survival differed from 38 months in hypocellular, 42 months in normocellular, and 25 months in hypercellular MDS (P < 0.0005). AML progression rates were 33% for hypercellular MDS after 2 yr, whereas hypo- and normocellular had a progression rate of 19% after 2 yr (P = 0.018). IPSS and IPSS-R were able to identify different risk groups within all three cellularity groups.
  
  
  CONCLUSIONS
  Based on our data, hypocellular patients obviously do not present as a separate entity, as there were no striking differences with regard to cytogenetics and WHO types. Assessment of cellularity should be performed by histopathology.
authors.affiliation: Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schemenau
authors.affiliation: Department of Pathology, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Baldus
authors.affiliation: Department of Pathology, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Anlauf
authors.affiliation: Department of Pathology, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Reinecke
authors.affiliation: Department of Pathology, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Braunstein
authors.affiliation: Department of Hematology and Oncology, University of Lausanne, Lausanne, Switzerland.
authors.forename: Sabine
authors.initials: S
authors.lastname: Blum
authors.affiliation: Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Nachtkamp
authors.affiliation: Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Neukirchen
authors.affiliation: Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Corinna
authors.initials: C
authors.lastname: Strup
authors.affiliation: St Johannes Hospital, Hematology, Oncology, and Clinical Immunology, Duisburg, Germany.
authors.forename: Carlo
authors.initials: C
authors.lastname: Aul
authors.affiliation: Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Haas
authors.affiliation: Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Gattermann
authors.affiliation: Department of Hematology, Oncology, and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Germing
mesh_terms: D001853:Bone Marrow / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006403:Hematologic Tests; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000209:etiology; D008297:Male; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000175:diagnosis / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D011379:Prognosis
keywords: bone marrow cellularity; cytogenetics; myelodysplastic syndromes; prognosis