Abstract
In the FAB (French-American-British) and WHO (World Heath Organization) classifications, the blasts in erythroleukemia (M6a) are enumerated from the marrow nonerythroid rather than the total-nucleated cells. However, the method for blast calculation in erythroid-predominant myelodysplastic syndrome (erythroblasts≥50%) is not specified either in the FAB or WHO classifications. We retrieved the files of 74 erythroid-predominant myelodysplastic syndrome patients (17% of all myelodysplastic syndrome) and 192 myelodysplastic syndrome controls (erythroblasts<50%). In erythroid-predominant myelodysplastic syndrome, by enumerating blasts from marrow nonerythroid cells rather than from total nucleated cells, 41 of 74 (55%) cases would be upgraded, either by disease subcategory or International Prognostic Scoring System. Importantly, the patients with <5% blasts demonstrated a superior survival to patients with ≥5% blasts (P=0.002); this distinction was lost when blasts were calculated from total-nucleated cells. Of cases with ≥5% blasts, cytogenetics rather than blast count correlated with survival. We conclude that in erythroid-predominant myelodysplastic syndrome, blast calculation as a proportion of marrow nonerythroid rather than total nucleated cells can better stratify patients into prognostically relevant groups.
Original language | English (US) |
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Pages (from-to) | 1394-1402 |
Number of pages | 9 |
Journal | Modern Pathology |
Volume | 21 |
Issue number | 11 |
DOIs | |
State | Published - Nov 2008 |
Keywords
- Blasts enumeration
- Erythroid precursors
- Myelodysplastic syndrome
- Prognosis
- Survival
ASJC Scopus subject areas
- Pathology and Forensic Medicine