难治性血细胞减少伴多系发育异常的回顾性诊断分析

目的回顾分析难治性血细胞减少伴多系发育异常(RCMD)患者依据不同的分型标准所得分型结果,进而探讨RCMD的临床特征、实验室检查及形态学特点。方法选取按FAB中MDS诊断标准(FAB-MDS)诊断的难治性贫血(RA)/伴环形铁粒幼细胞增多的难治性贫血(RAS)患者59例,按WHO-MDS分型标准进行回顾性诊断分析,比较两者之间的异同。结果59例患者中,50例RA患者按WHO-MDS诊断标准,有14例(28.0%)仍归入了RA中,36例(72.0%)归入了RCMD;另外9例RAS患者,5例仍诊断为RAS,4例归入了RCMD-RS中。结论依据不同的分型标准,部分RCMD患者的归属类型不同。准确掌握RCMD的临床特征,有利于RCMD的准确定型。

Retrospective Analysis of Diagnosis for Patients with Refractory Cytopenia Associated with Multilineage Dysplasia

Objective To retrospectively analyze the typing results according to different typing criteria for patients with refractory cytopenia associated with multilineage dysplasia(RCMD)so as to further explore the clinical features,characteristics of RCMD in laboratory tests and morphology.Methods Totally 59 patients with refractory anemia(RA)or RA with ringed sideroblasts(RAS)according to the standard of French-American-British(FAB)were enrolled.The retrospective analysis of diagnosis of the patients was made based on the standard of WHO thus to compare the difference and identity of the two classification systems.Results According to the new WHO classification,in 50 cases diagnosed as RA in 59 patients,14 cases(28.0%)still pertained to RA,36 patients(72.0%)to RCMD.In another 9 cases of RAS,5 cases still pertained to RAS,however 4 case to RCMD with ringed sideroblasts(RCMD-RS).Conclusion Based on different classification standards,the diagnoses of some patients with RCMD were different.To accurately master the clinical features of RCMD is helpful to determine the right classification of RCMD.