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Minimal morphological criteria for defining bone marrow dysplasia: a basis for clinical implementation of WHO classification of myelodysplastic syndromes
- Source :
- Leukemia. 29(1)
- Publication Year :
- 2014
-
Abstract
- The World Health Organization classification of myelodysplastic syndromes (MDS) is based on morphological evaluation of marrow dysplasia. We performed a systematic review of cytological and histological data from 1150 patients with peripheral blood cytopenia. We analyzed the frequency and discriminant power of single morphological abnormalities. A score to define minimal morphological criteria associated to the presence of marrow dysplasia was developed. This score showed high sensitivity/specificity (>90%), acceptable reproducibility and was independently validated. The severity of granulocytic and megakaryocytic dysplasia significantly affected survival. A close association was found between ring sideroblasts and SF3B1 mutations, and between severe granulocytic dysplasia and mutation of ASXL1, RUNX1, TP53 and SRSF2 genes. In myeloid neoplasms with fibrosis, multilineage dysplasia, hypolobulated/multinucleated megakaryocytes and increased CD34+ progenitors in the absence of JAK2, MPL and CALR gene mutations were significantly associated with a myelodysplastic phenotype. In myeloid disorders with marrow hypoplasia, granulocytic and/or megakaryocytic dysplasia, increased CD34+ progenitors and chromosomal abnormalities are consistent with a diagnosis of MDS. The proposed morphological score may be useful to evaluate the presence of dysplasia in cases without a clearly objective myelodysplastic phenotype. The integration of cytological and histological parameters improves the identification of MDS cases among myeloid disorders with fibrosis and hypocellularity.
- Subjects :
- Adult
Male
Cancer Research
Pathology
medicine.medical_specialty
Myeloid
diagnosis
CD34
World Health Organization
Severity of Illness Index
NO
chemistry.chemical_compound
Bone Marrow
hemic and lymphatic diseases
medicine
Humans
Prognostic scoring system
acute myeloid-leukemia
world-health-organization
mutations
mds
recommendations
fibrosis
anemia
Aged
Cytopenia
business.industry
Myelodysplastic syndromes
Hematology
Middle Aged
medicine.disease
medicine.anatomical_structure
Hypocellularity
Oncology
RUNX1
chemistry
Dysplasia
Myelodysplastic Syndromes
Female
Bone marrow
business
Subjects
Details
- ISSN :
- 14765551
- Volume :
- 29
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Leukemia
- Accession number :
- edsair.doi.dedup.....ed0397a921afa14f43e36283ceee64ef