Refractory anemia with severe dysplasia: clinical significance of morphological features in refractory anemia

Leukemia
A MatsudaK Hirashima

Abstract

Refractory anemia (RA) in myelodysplastic syndromes (MDS) are very heterogeneous diseases regarding their morphology, clinical features and survival. We proposed the new designations 'RA with severe dysplasia (RASD)' and 'RA with minimal dysplasia (RAminiD)'. In our criteria, RASD is considered present if a bone marrow (BM) examination shows Pseudo-Pelger-Huet anomalies of mature neutrophils > or =3% and/or micromegakaryocytes (mMgk) of megakaryocytes > or =10% in RA patients. RAminiD is defined as RA cases other than RASD. After the reclassification of 58 primary RA patients, the group was composed of 45 RAminiD and 13 RASD patients. The blast percentage in the BM and the frequency of cytogenetic abnormalities observed in the RASD patients were intermediate between those in the RAminiD and RAEB patients. The analysis of survival curves revealed differences among the three groups; the RASD patients had lower survival probabilities than those of the RAminiD group, and significantly higher probabilities than those of the RAEB group. (RAminiD vs RASD, P=0.06; RASD vs RAEB, P=0.004.) Our data indicate that in RA patients, RASD is a distinct subset of RA with an unfavorable clinical outcome.

Citations

Jun 26, 2008·Annals of Hematology·Ulrich GermingJohn M Bennett
Dec 8, 2010·Current Hematologic Malignancy Reports·Fabio P S SantosFarhad Ravandi
Jan 16, 2003·Leukemia Research·David P Steensma, Ayalew Tefferi
Apr 20, 2005·Annals of Hematology·A Cantù RajnoldiUNKNOWN European Working Group on Myelodysplastic Syndromes in Childhood (EWOG-MDS)
Jan 11, 2007·American Journal of Clinical Pathology·Zeba N SinghJames W Vardiman
Mar 21, 2012·Cytometry. Part B, Clinical Cytometry·Sara A MonaghanFiona E Craig
Sep 18, 2012·Leukemia Research·Ulrich Germing, Andrea Kündgen
Jun 20, 2002·Radiation Research·Nobuhiko BanMichiaki Kai

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