What factors affect the prognosis of myelodysplastic syndrome?

myelodysplastic syndromes (MDS) are a group of disorders involving abnormal myeloid stem cells. Myeloid stem cells are produced by bone wood and develop on white blood cells (WBC), red blood cells (RBC) or plates and myeloid stem cell disorders are a potentially threatening life. Doctors mainly use the prognosis of myelodysplastic syndrome of the International Prognostic Scoring System (IPSS) or the World Health Organization Prognostic scoring system (WPSS). Both of these systems use factors, including the percentage of myoblasts of bone marrow, cytogenic abnormalities, the number of cytopenics, gender and age to predict the possible results of patients. Activity Lactate dehydrogenase in blood serum and patient dependence on blood transfusions may also be useful for the prognosis of myelodysplastic syndrome.H as benzene or for unknown reasons. MDS can cause cytopenia or insufficient numbers of WBC, RBC cells or platelet cells or abnormalities in these cells. PatientsIron overload may also develop. Some types of MDS can advance to acute myeloid leukemia (AML), so MDS is sometimes called "preleukemia" or "smoldering leukemia". The accuracy of the prognosis of myelodysplastic syndrome is important in determining the best treatment of patients and for the classification of participants in a medical study.

Scientists at the MDS Risk Analysis Workshop have developed IPSS in 1997 and has since become the most commonly used system for myelodysplastic syndrome. IPSS divides MDS cases into categories depending on the percentage of myoblasts of bone marrow, cytogenic abnormalities and the number of cytopenies. Doctors use these categories to determine the prognosis of myelodysplastic syndrome, which includes the pathiinated overall survival and the risk of developing leukemia.

Using IPSS criteria, MDS patients with too little red blood cells but normal platelet levels and white blood cellsThey suffer from refractory anemia (RA) and RA patients whose red blood cells also contain too iron anemia with ring sideoblasts (rars). Refractory anemia with excess explosions (RAEB) refers to MDS with too small a number of red blood cells and in which from 5 percent to 19 percent of the blood cells in the bone marrow are explosions or immature blood cells, along with possible white blood cells and abnormalities of plates. Patients with MDS with too small RBC, WBC and platelet, who contain explosions of 20 to 30 percent of blood cells in the bone marrow and 5 percent or more in the blood, suffer from refractory anemia with excess explosions in transformation (RAEB-T). Refractory cytopenia with multilineage dysplasia (RCMD) means that the patient has too little more than one type of blood cells. Some cases of myodydysplastic syndrome are associated with isolated abnormality of DEL chromosome (5Q) and non -classified MDS cases include cytopenia of one type of blood cell and a normal number of explosions.

Workshop of Risk AnalysisTo the MDS he found that patients suffering from Rars are likely to survive the longest, followed by RA patients. Patients with Raeb had a significantly lower lifetime than patients with Rars or RA and RaEb-T patients had the shortest expected survival; None of the Raeb-T patients in the analysis did not live more than 5.5 years after diagnosis with MDS. The prognosis of myelodysplastic syndrome was more positive for patients than in men and patients over 60 have reduced survival. Patients with Rars and Ra had the least chance of developing AML, while patients with RAEB had a significantly higher risk. All patients with RAEB-T studied in the workshop developed AML within four years of diagnosis of MDS.

WPSS divides RAEB into types of one and two (RAEB-1 and RAEB-2) for the purposes of myelodysplastic syndrome. From 5 percent to 9 percent of blood cells in bone marrow in patients with RAEB-1 are explosions and less than 5 percent in the blood are explosions. In patients with RAEB-2, from 10 percent to 19 percent of the blood cells in the bone marrow and from 5 percent to 19 percent of blood cells in the blood, they are explosions. PatientsWith RAEB-1 they have about 25 % risk of developing AML, while patients with RAEB-2 are at 33 percent.

After the development of IPSS and WPSS, scientists have identified more factors that affect the risk of leukemia and overall survival in MDS patients. Patients with MDS without excessive explosions and who are dependent on blood transfusions have a significantly higher risk of leukemia and shorter overall survival than patients who do not need transfusions. Transfusion dependence is also an important independent risk factor for patients with Rars and Del (5Q) MDS. Patients with MDS who have a higher level of white blood cells for time diagnosis of MDS tends to survive longer and patients with high activity lactate dehydrogenase in serum have reduced overall survival. Since mid -2011, scientists have continued their efforts to improve the prognosis of myelodysplastic syndrome.