Myelodysplastic syndrome classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]

Overview

The myelodysplastic syndrome may be classified into several subtypes based on the French-American-British (FAB) classification and theWorld Health Organization (WHO) classification methods.

Classification

French-American-British (FAB) Classification

  • Myelodysplastic syndrome may be classified according to the French-American-British classification into five groups: Refractory anemia, refractory anemia with ring sideroblasts, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, and chronic myelomonocytic leukemia.
  • The table below lists FAB classification for myelodysplastic syndrome:[1]
Name Description
Refractory anemia
  • Less than 5% primitive blood cells (myeloblasts) in the bone marrow and pathological abnormalities primarily seen in red blood cell precursors.
Refractory anemia with ring sideroblasts (RARS)
  • Less than 5% myeloblasts in the bone marrow, but distinguished by the presence of ringed sideroblasts which may compose greater than 15% of red blood cell precursor in the marrow.
Refractory anemia with excess blasts (RAEB)
  • 5-20% myeloblasts in the marrow
Refractory anemia with excess blasts in transformation (RAEB-T)
  • 21-30% myeloblasts in the marrow (>30% blasts is defined as acute myeloid leukemia)
Chronic myelomonocytic leukemia (CMML)
  • Less than 20% myeloblasts in the bone marrow and greater than 1*109/L monocytes in peripheral blood

WHO Classification

  • The table below lists World Health Organization classification for myelodysplastic syndrome:[1][2][3]
2008 2016
Refractory cytopenia with unilineage dysplasia (RCUD)
  •    Refractory anemia (RA)
  •    Refractory neutropenia (RN)
  •    Refractory thrombocytopenia (RT)
MDS with single lineage dysplasia (MDS-SLD)
Refractory anemia with ring sideroblasts (RARS) MDS with ring sideroblasts (MDS-RS)
  • MDS-RS-SLD
  • MDS-RS-MLD
Refractory cytopenias with multilineage dysplasia MDS with multilineage dysplasia (MDS-MLD)
Refractory anemia with excess blasts (RAEB)
  • RAEB-1
  • RAEB-2
MDS with excess blasts (MDS-EB)
  • MDS-EB-1
  • MDS-EB-2
MDS with isolated del(5q) MDS with isolated del(5q)
MDS, unclassifiable (MDS-U) MDS, unclassifiable (MDS-U)
Refractory cytopenia of childhood (provisional) Refractory cytopenia of childhood (provisional)

References

  1. 1.0 1.1 Pathologic systems of myelodysplastic syndrome. National Cancer Institute (2015). http://www.cancer.gov/types/myeloproliferative/hp/myelodysplastic-treatment-pdq/#link/_204_toc. Accessed on December 7, 2015
  2. Hong M, He G (September 2017). "The 2016 Revision to the World Health Organization Classification of Myelodysplastic Syndromes". J Transl Int Med. 5 (3): 139–143. doi:10.1515/jtim-2017-0002. PMC 5655460. PMID 29085786.
  3. Arber, D. A.; Orazi, A.; Hasserjian, R.; Thiele, J.; Borowitz, M. J.; Le Beau, M. M.; Bloomfield, C. D.; Cazzola, M.; Vardiman, J. W. (2016). "The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia". Blood. 127 (20): 2391–2405. doi:10.1182/blood-2016-03-643544. ISSN 0006-4971.

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