title: MDS prognostic scoring systems – past, present, and future.
abstract: The myelodysplastic syndromes (MDS) are a heterogeneous group of clonal myeloid haemopathies characterized by defective differentiation of haematopoietic cells and expansion of the abnormal clone. This leads to bone marrow failure with the resulting peripheral blood cytopenias and evolution to or toward acute myeloid leukaemia that characterize MDS clinically. The clinical heterogeneity of MDS has led several groups to analyze patient and clinical characteristics to develop prognostic scoring systems yielding estimates of overall and leukaemia-free survival to guide clinical decision-making. These models have evolved over time as our understanding of the pathogenesis, natural history, and treatment of MDS has improved. Rapid advances in flow cytometric analysis, adjuncts to standard metaphase cytogenetics, and gene mutation analysis are revolutionizing our understanding of MDS pathogenesis and prognosis. Despite the existence of multiple well-validated prognostic scoring systems, further refinements of current models with these new sources of prognostic data are needed and are described herein.
authors: Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis School of Medicine, UC Davis Comprehensive Cancer Center, 4501 X Street, Suite 3016, Sacramento, CA 95817, United States. Electronic address: brian.jonas@ucdmc.ucdavis.edu.
authors: Brian A
authors: BA
authors: Jonas
authors: Department of Internal Medicine, Division of Hematology, Stanford University School of Medicine, Stanford Comprehensive Cancer Center, 875 Blake Wilbur Drive, Stanford, CA 94305, United States. Electronic address: peterg@stanford.edu.
authors: Peter L
authors: PL
authors: Greenberg
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001854:Bone Marrow Cells / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D049109:Cell Proliferation; D018450:Disease Progression; D015870:Gene Expression; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality; D009154:Mutation; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality; D009363:Neoplasm Proteins / Q000235:genetics* / Q000378:metabolism; D011379:Prognosis; D012107:Research Design; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents; D009363:Neoplasm Proteins
keywords: cytogenetics; flow cytometry; gene expression; mutations; myelodysplastic syndromes; prognosis