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      Myelodysplastic syndrome versus idiopathic cytopenia of undetermined significance: the role of morphology in distinguishing between these entities

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          Abstract

          Myelodysplastic syndrome (MDS) is a heterogeneous group of diseases characterized by ineffective and dysplastic hematopoiesis and pancytopenia in the peripheral blood(1). Minimal diagnostic criteria for MDS have been discussed by several working groups. The term idiopathic cytopenia of undetermined significance (ICUS) has been proposed to define patients who do not fill minimal criteria for MDS but present with persistent cytopenia not attributable to a hematological or non-hematological disease(2). In medical services where immunohistochemistry, cytogenetics and studies of progenitor cell assays are still not available, the morphologic parameters may be the center of the diagnosis of ICUS. Several working groups have also discussed minimal morphological criteria for 'bone marrow dysplasia'. Based on these discussions, at least 10% of all cells in a given lineage should produce signs of dysplasia to fill this important criterion(3). Patients with ICUS present mild dysplasia in one or more hematopoietic lineages. Figures 1 & 2 illustrate the myelogram of one patient with ICUS and one patient with MDS showing the levels of dysplasia in both settings. Distinguishing between these entities is important to understand the similarities and differences in pathologic mechanisms of the two hematologic diseases and so to direct the correct management of patients. Figure Figure 1A and 1B – Mild dyserythropoiesis (<10%) in patient with ICUS; presence of blabs. Figure 2A – Dyserythropoiesis (> 10%). Figure 2B – Dysmegakaryopoiesis; presence of blasts in patient with MDS (magnification: 1000x; HE stain)

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          Distinguishing myelodysplastic syndromes (MDS) from idiopathic cytopenia of undetermined significance (ICUS): HUMARA unravels clonality in a subgroup of patients

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            Distinguishing myelodysplastic syndromes (MDS) from idiopathic cytopenia of undetermined significance (ICUS): HUMARA unravels clonality in a subgroup of patients.

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              Idiopathic cytopenia of undetermined significance (ICUS) and idiopathic dysplasia of uncertain significance (IDUS), and their distinction from low risk MDS.

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                Author and article information

                Journal
                Rev Bras Hematol Hemoter
                Rev Bras Hematol Hemoter
                Rev Bras Hematol Hemoter
                Revista Brasileira de Hematologia e Hemoterapia
                Associação Brasileira de Hematologia e Hemoterapia
                1516-8484
                1806-0870
                2013
                : 35
                : 6
                : 438-439
                Affiliations
                Universidade Federal do Ceará - UFC, Fortaleza, CE, Brazil
                Author notes
                Corresponding author: Talyta Ellen de Jesus dos Santos, Universidade Federal do Ceará, Departamento de Análises Clínicas e Toxicológicas, Rua Capitão Francisco Pedro, 1210 - Rodolfo Teófilo, 60430-370 Fortaleza, CE, Brazil. talytaellen08@ 123456hotmail.com
                Article
                10.5581/1516-8484.20130069
                3905828
                24478612
                f424d771-53d3-42b7-a4cd-e2c0f7f3c7ac

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 May 2013
                : 05 June 2013
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                Hematology
                Hematology

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