Abstract
Increased understanding of the biologic and clinical parameters that define subgroups of myelodysplastic syndromes has led to continuing refinement of classification strategies for diagnostic and prognostic use. The French-American-British classification, based primarily on morphology, was modified by the World Health Organization system to include the negative impact of multilineage dysplasias and higher blast counts. In addition, this system identifies a distinct clinical subgroup characterized by an isolated chromosome 5 deletion. The International Prognostic Scoring System was created to calculate prognosis, risk of transformation to acute myeloid leukemia, and median survival times. However, therapeutic decisions cannot be solely guided by these systems, and the clinician must decide whether the intent is curative or palliative. Clinical symptoms and degree of transfusion dependency will dictate the degree of therapeutic intervention.
Similar content being viewed by others
References and Recommended Reading
Block M, Jacobson LO, Bethard WF: Preleukemic acute human leukemia. J Am Med Assoc 1953, 152:1018–1028.
Bennett JM, Catovsky D, Daniel MT, et al.: Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group. Br J Haematol 1976, 33:451–458.
Bennett JM, Catovsky D, Daniel MT, et al.: Proposals for the classification of the myelodysplastic syndromes. Br J Haematol 1982, 51:189–199.
Harris NL, Jaffe ES, Diebold J, et al.: World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting—Airlie House, Virginia, November 1997. J Clin Oncol 1999, 17:3835–3849.
Mufti GJ, Stevens JR, Oscier DG, et al.: Myelodysplastic syndromes: a scoring system with prognostic significance. Br J Haematol 1985, 59:425–433.
Sanz GF, Sanz MA, Vallespí T, et al.: Two regression models and a scoring system for predicting survival and planning treatment in myelodysplastic syndromes: a multivariate analysis of prognostic factors in 370 patients. Blood 1989, 74:395–408.
Morel P, Hebbar M, Lai JL, et al.: Cytogenetic analysis has strong independent prognostic value in de novo myelodysplastic syndromes and can be incorporated in a new scoring system: a report on 408 cases. Leukemia 1993, 7:1315–1323.
Aul C, Gattermann N, Heyll A, et al.: Primary myelodysplastic syndromes: analysis of prognostic factors in 235 patients and proposal for an improved scoring system. Leukemia 1992, 6:52–59.
Greenberg P, Cox C, LeBeau MM, et al.: International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood 1997, 89:2079–2088.
Germing U, Gattermann N, Minning H, et al.: Problems in the classification of CMML—dysplastic versus proliferative type. Leuk Res 1998, 22:871–878.
Vardiman JW, Harris NL, Brunning RD: The World Health Organization (WHO) classification of the myeloid neoplasms. Blood 2002, 100:2292–2302.
Onida F, Kantarjian HM, Smith TL, et al.: Prognostic factors and scoring systems in chronic myelomonocytic leukemia: a retrospective analysis of 213 patients. Blood 2002, 99:840–849.
Solé F, Luño E, Sanzo C, et al.: Identification of novel cytogenetic markers with prognostic significance in a series of 968 patients with primary myelodysplastic syndromes. Haematologica 2005, 90:1168–1178.
Bernasconi P, Klersy C, Boni M, et al.: Incidence and prognostic significance of karyotype abnormalities in de novo primary myelodysplastic syndromes: a study on 331 patients from a single institution. Leukemia 2005, 19:1424–1431.
Quddus F, Ahmed A, Salman S, et al.: Validation of IPSS criteria in more than sixteen hundred MDS patients [abstract]. J Clin Oncol 2007, 25. Abstract 7079.
Germing U, Gattermann N, Strupp C, et al.: Validation of the WHO proposals for a new classification of primary myelodysplastic syndromes: a retrospective analysis of 1600 patients. Leuk Res 2000, 24:983–992
Nosslinger T, Reisner R, Koller E, et al.: Myelodysplastic syndromes, from French-American-British to World Health Organization: comparison of classifications on 431 unselected patients from a single institution. Blood 2001, 98:2935–2941.
Malcovati L, Porta MG, Pascutto C, et al.: Prognostic factors and life expectancy in myelodysplastic syndromes classified according to WHO criteria: a basis for clinical decision making. J Clin Oncol 2005, 23:7594–7603.
Lee J-H, Lee J-H, Shin Y-R, et al.: Application of different prognostic scoring systems and comparison of the FAB and WHO classifications in Korean patients with myelodysplastic syndrome. Leukemia 2003, 17:305–313.
Germing U, Strupp C, Kuendgen A, et al.: Prospective validation of the WHO proposals for the classification of myelodysplastic syndromes. Haematologica 2006, 91:1596–1604.
Cutler CS, Lee SJ, Greenberg P et al.: A decision analysis of allogeneic bone marrow transplantation for the myelodysplastic syndromes: delayed transplantation for low-risk myelodysplasia is associated with improved outcome. Blood 2004, 104:579–585.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Galili, N., Raza, A. Prognosis in myelodysplastic syndromes: Are the new classifications useful?. Curr Hematol Malig Rep 3, 19–22 (2008). https://doi.org/10.1007/s11899-008-0004-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11899-008-0004-z