268 - 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
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2
Q

What are the most important prognostic factors for MDS? (2)

A

Blast count

Cytogenetic abnormalities

*Don’t need to memorize specific abnormalities

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3
Q

Pts with MDS with which chromosomal abnormality can be treated with lenalidomide?

A

del (5q)

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4
Q

What are the clinical features of MDS? (3)

A

Anemia

Neutropenia

Thrombocytopenia

Pts with MDS will always have cytopenia

*No organomegaly (vs. CML)

*Slow onset (vs. AML)

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5
Q

Describe the general difference in the cells of origin of:

  • CML:
  • AML:
  • MDS:
A
  • CML: Neoplastic fully matured myeloid cells
    • <20% blasts in peripheral blood
  • AML: Neoplastic myeloid precursors
    • >20% blasts in peripheral blood
  • MDS: abnormal cells across myeloid lines
    • Cytopenia
    • <20% peripheral blasts

MDS has a 10-40% chance of transforming to AML

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6
Q

What are the major risk factors for MDS?

A

Benzene

Chemo

Radiation

Tobacco

Fanconi anemia

Dyskeratosis congenita

I think the bold ones were more emphasized in lecture

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7
Q

What chromosomal abnormalities are associated with myelodysplastic sydrome?

A

Loss of part of 5

Loss of part of 7

11q23 deletion

In general, MDS has more gains or losses

(vs. leukemia has more translocations)
* Deletion of 5q has better prognosis*

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8
Q

What qualifies as “MDS with excess blasts”?

A

5-19%

  • MDS with excess blasts 1 = 5-9%
  • MDS with excess blasts 2 = 10-19%

Poor prognosis in general :(

Note: >20% blasts is AML

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