265 - MDS (Myelodysplastic Syndromes) Flashcards
1
Q
What is the key finding on bone marrow biopsy in MDS?
A
Dysplasia
- Hypercellular
- Erythroid hyperplasia (increased precursors that are dysplastic)
- Granulocyte dysplasia
- Dysplastic megakaryocytes
Dysplasia can look like:
- Nuclear budding
- Intracellular bridging
- Multinucleation
- Bizzare nuclei
2
Q
What are the most important prognostic factors for MDS? (2)
A
- Blast count
- Cytogenetic abnormalities
*Don’t need to memorize specific abnormalities
3
Q
Pts with MDS with which chromosomal abnormality can be treated with lenalidomide?
A
del (5q)
4
Q
What are the clinical features of MDS? (3)
A
- Anemia
- Neutropenia
- Thrombocytopenia
-
Pts with MDS will always have cytopenia
- all clinical features are associated w/ cytopenia
*No organomegaly (vs. CML)
*Slow onset (vs. AML)
5
Q
Describe the general difference in the cells of origin of:
- CML:
- AML:
- MDS:
A
-
CML: overgrowth of neoplastic fully matured myeloid cells
- <20% blasts (immature) in peripheral blood
-
AML: overgrowth of neoplastic myeloid precursors (blasts) without maturation
- >20% blasts in peripheral blood
-
MDS: abnormal growth of neoplastic myeloid cells
- peripheral cytopenia (ineffective hematopoiesis)
- <20% peripheral blasts (immature)
- MDS has a 10-40% chance of transforming to AML
6
Q
What are the major risk factors for MDS?
A
- Benzene + tobacco
- Chemo and radiation –> therapy related MDS
- Fanconi anemia
- Dyskeratosis congenita
I think the bold ones were more emphasized in lecture
7
Q
What chromosomal abnormalities are associated with myelodysplastic sydrome?
A
- Loss of part of ch 5
- Loss of part of ch 7
- gain of part of ch 8
- In general, MDS has more gains or losses (vs. leukemia, which has more translocations)
Deletion of 5q has better prognosis
8
Q
What qualifies as “MDS with excess blasts”?
A
5-19% blasts
- MDS with excess blasts 1 = 5-9%
- MDS with excess blasts 2 = 10-19%
Poor prognosis in general :(
Note: >20% blasts is AML
