Ann Lab Med 2017; 37(6): 465-474  
Diagnostics and Prognostication of Myelodysplastic Syndromes
Gina Zini, M.D.
Department of Oncology and Hematology, Blood Transfusion Service, Policlinico Gemelli Foundation, Catholic University of Sacred Heart, Rome, Italy
Correspondence to: Gina Zini
Department of Oncology and Hematology, Blood Transfusion Service, Policlinico Gemelli Foundation, Catholic University of Sacred Heart, L.go Gemelli 8, Rome 00168, Italy
Tel: +39-06-30153262 Fax: +39-06-3055153 E-mail: gina.zini@unicatt.it
Received: April 25, 2017; Revised: June 7, 2017; Accepted: August 2, 2017; Published online: November 1, 2017.
© The Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
MDS are a heterogeneous and complex group of clonal hematological neoplasms arising from a hematopoietic stem cell, and characterized by ineffective hematopoiesis, resulting in increased apoptosis in the bone marrow and peripheral cytopenia, which involves one or more lineages. Epigenetic changes are reported as ‘founder’ mutations in the case of MDS. Its incidence in the general population has been reported as five new MDS diagnoses per 100,000 people. It affects men more frequently than it does women, and its incidence increases with age. The diagnostic classification, now in use, is the one of the World Health Organization, revised in August 2016. It recognizes six distinct entities in addition to a provisional entity of childhood. In most of the cases, diagnosis is based on the morphologic quantitative and qualitative evaluation of the peripheral blood and bone marrow using basic hematological techniques. Bone marrow biopsy and flow cytometric immunophenotyping also offer support for further diagnostic elucidation, while cytogenetics and molecular genetics are presently fully integrated into prognostication, treatment processes, and decision-making.
Keywords: Myelodysplastic syndromes (MDS), WHO 2016 classification, Diagnosis, Prognostication


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