Prognosis

by Biblia Kim

MDS patients, with over 20 to 30 percent of immature stem cells (blasts), are diagnosed with acute myelogenous leukemia (AML), a form of cancer.

Approximately one-third of MDS patients progress to AML. The risk of MDS transforming into AML increases with prior exposure to chemotherapy and radiation treatment.

In general, indicators of a good MDS prognosis include normal or moderately reduced while blood cell or platelet counts, less than 20 percent of blasts in the bone marrow, and abnormal red blood cells (ringed sideroblasts). Also, young patients have a low likelihood of developing AML.

By contrast, indicators of poor MDS prognosis include a severe lack of white blood cells or platelets, blast percentages between 20 to 29 percent, and the presence of blasts in the blood (Auer rods). Karyotypes, which are organized profiles of an individual’s chromosomes arranged by size and type, are also used to give prognoses. An abnormal karyotype that shows complex bone marrow chromosome abnormalities is an indicator of a poor prognosis.

Chromosomal aberrations are also good predictors of MDS. Patients with an extra copy of chromosome 8, a missing Y chromosome, or a missing part (the ‘q’ arm) of chromosome 5 are more likely to have a better prognosis than patients with other abnormalities. In general, patients with chromosome 7 anomalies or more than three abnormalities are more likely to have a poorer prognosis.

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