Standards and Impact of Hematopathology in Myelodysplastic Syndromes (MDS)

Abstract

AbstrAct:The diagnosis, classification, and prognostication of patients with myelodysplastic syndromes (MDS) are usually based on clinical parameters, analysis of peripheral blood and bone marrow smears, and cytogenetic determinants. However, a thorough histologic and immunohistochemical examination of the bone marrow is often required for a final diagnosis and exact classification in these patients. Notably, histology and immunohistology may reveal dysplasia in megakaryocytes or other bone marrow lineages and/or the presence of clusters of CD34-positive precursor cells. In other cases, histology may reveal an unrelated or co-existing hematopoietic neoplasm, or may support the conclusion the patient is suffering from acute myeloid leukemia rather than MDS. Moreover, histologic investigations and immunohistology may reveal an increase in tryptase-positive cells, a coexisting systemic mastocytosis, or bone marrow fibrosis, which is of prognostic significance. To discuss diagnostic algorithms, terminologies, parameters, and specific issues in the hematopathologic evaluation of MDS, a Working Conference involving a consortium of US and EU experts, was organized in June 2010. The outcomes of the conference and resulting recommendations provided by the faculty, are reported in this article. These guidelines should assist in the diagnosis, classification, and prognostication in MDS in daily practice as well as in clinical trials.

The underestimated role of basophils in Ph+ chronic myeloid leukaemia

“…48,49 In addition, immature BM basophils express KIT and tryptase. 50 It has also been described that basophils in CML can be detected and enumerated by 2D7 or BB1 staining and that the numbers of 2D7 + and BB1 + cells (basophils) correlate with the phase of CML. 48,49 However, both antibodies may also react with immature eosinophils in the leukaemic BM (P. Valent and H.-P. Horny, personal observation).…”

Is There a Role for Flow Cytometry in the Evaluation of Patients With Myelodysplastic Syndromes?

“…Use of the RED-score allowed correct classification of 80 % of MDS and non-MDS BM samples, and the combination of the RED-score with the Ogata score gave sensitivity of 88 % in differentiating between MDS and non-MDS BM samples [7]. Megakaryocytic dysplasia is traditionally evaluated by morphology and immunohistochemistry on BM biopsy material [49]. Analysis of the megakaryocytic lineage by FCM is difficult due to paucity of megakaryocytes in the BM cell suspensions, their large cell size, and cellular complexity.…”

Retracted: EBF1 gene promotes the proliferation and inhibits the apoptosis of bone marrow CD34+ cells in patients with myelodysplastic syndrome through negative regulation of mitogen‐activated protein kinase axis

“…Myelodysplastic syndromes (MDS), also known as myelodysplastic neoplasms, belong to a heterogeneous group of bone marrow disorders, presenting themselves as a myeloid clonal disease stemming from hematopoietic precursors. 1,2 Having shown greater clinical manifestations and severe disease to people of an advanced age, elder people are more susceptible to MDS. 3 The main basis for the diagnosis of MDS patients involves analysis of bone marrow smears, peripheral blood, cytogenetic determinants, and clinical parameters.…”