Diagnosis and classification of myelodysplastic syndrome: International Working Group on Morphology of myelodysplastic syndrome (IWGM-MDS) consensus proposals for the definition and enumeration of myeloblasts and ring sideroblasts
Diagnosis and classification of myelodysplastic syndrome: International Working Group on Morphology of myelodysplastic syndrome (IWGM-MDS) consensus proposals for the definition and enumeration of myeloblasts and ring sideroblasts
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DOI：
10.3324/haematol.13405
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发表时间：
2008-11-01
期刊：
影响因子：
--
通讯作者：
Yoshimi, Ayami
中科院分区：
文献类型：
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作者：
Mufti, Ghulam J.;Bennett, John M.;Yoshimi, Ayami
骨髓增生异常综合征的分类是基于法国-美国-英国（FAB）和世界卫生组织（WHO）小组提出的形态学标准。准确计数母细胞，虽然对诊断骨髓增生异常综合征和预后组的分配是必不可少的，往往是困难的，由于不精确的标准的形态定义的母细胞和早幼粒细胞。由骨髓增生异常综合征领域的血液病理学家和血液学家组成的骨髓增生异常综合征形态学国际工作组（IWGM-MDS）审查了骨髓增生异常综合征所有亚型的骨髓形态学特征，并就一系列建议达成一致，包括对原始细胞和环形铁粒幼细胞的定义和计数的建议。建议（1）定义无颗粒或颗粒母细胞（替换先前的I、II和III型原始细胞），（2）将发育不良的早幼粒细胞与细胞学正常的早幼粒细胞和颗粒原始细胞区分开，（3）计数足够的细胞以给出精确的原始细胞百分比，特别是在对于诊断或预后重要的阈值处，以及（4）环形铁粒幼细胞定义为成红细胞，其中至少有5个铁粒颗粒覆盖至少三分之一的核周长。明确的定义和足够数量细胞的分类计数可能会提高骨髓增生异常综合征诊断和分类的准确性。建议应在卫生组织分类的范围内适用。
The classification of myelodysplastic syndromes is based on the morphological criteria proposed by the French-American-British (FAB) and World Health Organization (WHO) groups. Accurate enumeration of blast cells, although essential for diagnosis of myelodysplastic syndrome and for assignment to prognostic groups, is often difficult, due to imprecise criteria for the morphological definition of blasts and promyelocytes. An International Working Group on Morphology of Myelodysplastic Syndrome (IWGM-MDS) of hematopathologists and hematologists expert in the field of myelodysplastic syndrome reviewed the morphological features of bone marrows from all subtypes of myelodysplastic syndrome and agreed on a set of recommendations, including recommendations for the definition and enumeration of blast cells and ring sideroblasts. It is recommended that (1) agranular or granular blast cells be defined (replacing the previous type I, II and III blasts), (2) dysplastic promyelocytes be distinguished from cytologically normal promyelocytes and from granular blast cells, (3) sufficient cells be counted to give a precise blast percentage, particularly at thresholds that are important for diagnosis or prognosis and (4) ring sideroblasts be defined as erythroblasts in which there are a minimum of 5 siderotic granules covering at least a third of the nuclear circumference. Clear definitions and a differential count of a sufficient number of cells is likely to improve precision in the diagnosis and classification of myelodysplastic syndrome. Recommendations should be applied in the context of the WHO classification.