骨髓增生异常综合征采用WHO新分型建议的临床意义探讨

~~骨髓增生异常综合征采用WHO新分型建议的临床意义探讨(英文)@黄一虹$徐州医学院附属医院血液科!江苏徐州221002 @李德鹏$徐州医学院附属医院血液科!江苏徐州221002 @陈令松$徐州医学院第二附属医院!江苏徐州221006 @鹿群先$徐州医学院附属医院血液科!江苏徐州221002~~~~ 1 ] Greenberg PL. The myelodysplastic syndromes. In; Hoffinan R,Benz E, Shattil S, et al, eds. Hematology: Basic principles and PracticeM]. 3rd ed. New York, NY: Churchill Livingstone, 2000,1106-1129. Chinese 2] Benn…

New WHO classification for myelodysplastic syndrome and its clinical significance

Objective: To explore the evolution of the new classification for myelodysplastic syndrome from French -American- British (FAB) to World Health Orgamzation (WHO) and its clinical significance. Methods :68patients with primary MDS who were diagnosed according to FAB criteria were reclassified according to the WHO proposals mentioned above. All patients were evaluated for clinical features, blood and bone marrow parameters at the time of diagnosis and were followed up for survival and leukemic progression. Results: According to the FAB group criteria, 68 patients with diagnosed at our restitution were classified as follows: 32 patients with RA, 4 patients with RARS, 19 patients with RAEB, 9 patients with RAEB -T and 3 patients with CMML. In adopting the WHO proposals, only 56 patients remained classifiable, 12 patients with RAEB - T and CMML were excluded. The new distribution included 8 patients with RA, 2 patients with RARS, 27 patients with RCMD, 1 patient with del(5 q) syndrome,2 patients with MDS were unclassifiable, and 16 patients still with RAEB, of which 7 forms were RAEB Ⅰ and 9were RAEB Ⅱ . There was no significant difference in median overall survival time between RA and RCMD classified according to the WHO proposal. Survival time differences between RA or RCMD and RAEB were statistically significant. Survival time differences between RAEB Ⅰ (17months) and RAEB Ⅱ (11 months) were not statistically significant, but P = 0.06 indicated a certain trend toward significance. The transition rate into AML was considerably higher in RAEB Ⅱ than in RAEB Ⅰ . Conclusions:There is no significant superiority in evaluating prognosis between RA and RCMD classified according to the WHO proposal. RAEB is divided into 2 subtypes and RAEB - T was incorporated into the AML group, which can be more benefit to clinician lo choice therapeutic regimens and evaluate disease progonsis. Hypoplastic MDS and MDS with bone marrow fibrosis need not to be independently discriminated.