title: Proposal of criteria for dyserythropoiesis in the diagnosis of myelodysplastic syndromes.
abstract: The percentage manifesting dysplasia in bone marrow needed to qualify as significant is ≥10 % in each lineage. However, detailed analyses of this threshold have not been reported. Here, we analyzed dyserythropoiesis (dysE) in 109 myelodysplastic syndromes (MDS) patients with 21 immune thrombocytopenia (ITP)/12 hemolytic anemia (HA) patients as a control. In present study, mild megaloblastic erythroblasts were specifically named 'red cell with abnormal chromatin clumping (RCACC)'. RCACC ≥10 % in erythroblasts was observed in 29 % of ITP patients and 58 % of HA patients. The numbers of MDS patients with RCACC in erythroblasts <10, 10-19 and ≥20 % were 1, 3, and 105, respectively. We analyzed dysE criteria according to the WHO classification (original WHO dysE). Most of our MDS patients (98 %) had original WHO dysE ≥20 %. The ITP patients with original WHO dysE ≥10 % was 48 %, and there were no ITP patients had original WHO dysE ≥20 %. Sixty-seven percent of HA patients had original WHO dysE ≥10 %, and three patients (25 %) had original WHO dysE ≥20 %. Raising the threshold of the original WHO dysE from 10 to 20 or 30 % may provide more suitable criteria. If RCACC is not included in dysE criteria, we think that '10 %' is a suitable threshold for the determination of dyserythropoiesis.
authors.affiliation: Department of Hemato-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan. nkawaiii@saitama-med.ac.jp.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Kawai
authors.affiliation: Department of Hemato-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Matsuda
authors.affiliation: Department of Hemato-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
authors.forename: Itsuro
authors.initials: I
authors.lastname: Jinnai
authors.affiliation: Department of Pathology, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
authors.forename: Takaya
authors.initials: T
authors.lastname: Ichimura
authors.affiliation: Department of Pathology, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Kayano
authors.affiliation: Department of Hemato-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Okamura
authors.affiliation: Department of Hemato-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
authors.forename: Maho
authors.initials: M
authors.lastname: Ishikawa
authors.affiliation: Department of Hemato-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Maeda
authors.affiliation: Department of Hematology, Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Hata
authors.affiliation: Department of Hematology, Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: Department of Hemato-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Asou
authors.affiliation: Department of Hemato-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Bessho
authors.affiliation: Japanese Red Cross Nagasaki Atomic Bomb Hospital, Nagasaki, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Tomonaga
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology; D066264:Datasets as Topic; D004900:Erythroblasts / Q000473:pathology; D004920:Erythropoiesis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult
keywords: Diagnosis; Dyserythropoiesis; Dysplasia; Myelodysplastic syndromes