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FAB
Classification of Myelodysplastic
Syndromes (MDS)
Refractory
anemia (RA).
-
Cytopenia of at
least one lineage in the
peripheral blood (usually anemia)
-
Normal or
hypercellular bone marrow with
dysplastic changes
-
Less than 1
percent blasts in the peripheral
blood and less than 5 percent
blasts in the bone marrow
Refractory
anemia with ringed sideroblasts (RARS)
-
Cytopenia
(almost always anemia), dysplastic
changes, and the same percentages
of blood and bone marrow blasts as
in refractory anemia
-
Ringed
sideroblasts accounting for more
than 15 percent of all nucleated
cells in the bone marrow
Refractory
anemia with excess blasts (RAEB)
-
Cytopenia of
two or more lineages in the
peripheral blood
-
Dysplastic
changes in all three lineages
-
Less than 5
percent blasts in the peripheral
blood and between 5 and 20 percent
blasts in the bone marrow
Chronic
myelomonocytic leukaemia (CML)
-
Peripheral-blood monocytosis (monocyte
count, >1¬10 9 per liter)
-
Less than 5
percent blasts in the peripheral
blood and up to 20 percent blasts
in the bone marrow
Refractory
anemia with excess blasts in
transformation (RAEB-T)
-
Hematologic
features similar to those of
refractory anemia with excess
blasts
-
More than 5
percent blasts in the peripheral
blood or between 21 and 30 percent
blasts in the bone marrow or the
presence of Auer rods in the
blasts
International
Prognostic Scoring System for
Myelodysplastic Syndromes
|
Overall
Score
|
Median
Survival
(yr) |
|
Low (0) |
5.7 |
|
Intermediate
1 (0.5 or
1.0)
2 (1.5 or
2.0) |
3.5
1.2 |
|
High
(>/=2.5) |
0.4 |
The overall score
is the sum of the scores for bone
marrow blasts, karyotype, and
cytopenias. The percentage of blasts
is scored as follows: <5 percent, 0;
5 to 10 percent, 0.5; 11 to 20
percent, 1.5; and 21 to 30 percent,
2.0. Cytogenetic features associated
with a good prognosis (normal
karyotype, Y-, 5q-, or 20q-) are
scored as 0; those associated with a
poor prognosis (abnormal chromosome
7 or three or more abnormalities)
are scored as 1.0; and all other
cytogenetic abnormalities, which are
associated with an intermediate
prognosis, are scored as 0.5. A
score of 0 is assigned if the
patient has no cytopenia or only one
type, and a score of 0.5 is assigned
if the patient has two or three
types of cytopenia. The various
types of cytopenia are defined as
follows: hemoglobin, <10 g per
deciliter; absolute neutrophil
count, <1500 per cubic millimeter;
and platelet count, <100,000 per
cubic millimeter.
Related
Criteria
Classification of Neutropenia
Classification of Neutrophilia
Serum Levels That Differentiate Anemia of Chronic Disease from Iron-Deficiency Anemia
Diagnostic Criteria for Disseminated Intravascular Coagulation (DIC)
Clinical Conditions Associated with Disseminated Intravascular Coagulation (DIC)
Diagnostic Criteria for Idiopathic Hypereosinophilic Syndrome (HES)
Diagnostic Criteria for Systemic Mastocytosis (SM)
WHO Classification of Mastocytosis
Diagnostic Criteria for Heparin-Induced Thrombocytopenia (HIT)
More...
References:
-
Heaney
ML, Golde DW. Myelodysplasia.
N Engl J Med. 1999 May
27;340(21):1649-60.
[Medline]
-
Goldman
JM. Myeloproliferative and
myelodysplastic syndromes:
the future. Hematol Oncol
Clin North Am. 2003
Oct;17(5):1261-9.
[Medline]
-
Greenberg
P, Cox C, LeBeau MM, Fenaux
P, Morel P, Sanz G, Sanz M,
Vallespi T, Hamblin T,
Oscier D, Ohyashiki K,
Toyama K, Aul C, Mufti G,
Bennett J. International
scoring system for
evaluating prognosis in
myelodysplastic syndromes.
Blood. 1997 Mar
15;89(6):2079-88.
[Medline]
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Wintrobe's Clinical Hematology
11th edition (November 1, 2003)
Hematology: Basic Principles And Practice, by Ronald Hoffman
4th Bk&Cdr edition (December 3, 2004)
Clinical Diagnosis and Management by Laboratory Methods, by John Bernard Henry
20th edition (April, 2001)
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