Evolution in the diagnosis of myelodysplastic syndromes: Experience of Farhat Hached hospital

Abstract

Introduction: Myelodysplastic syndromes (MDS) are hematological malignancies very common in geriatric practice, characterized by abnormal differentiation and maturation of hematopoietic cells resulting in ineffective hematopoiesis. This ineffective hematopoiesis is responsible for blood cytopenias contrasted with a usually rich bone marrow. The result over the long term overall bone marrow failure and the risk of emergence of a more immature clone of cells by changing the SMD to an array of acute leukemia. The objective of this work is to show the evolution in the diagnostic approach MDS in the Farhat Hached University Hospital of Sousse. Methods: It’s about a bio-clinical review of a series of SMD diagnosed between 1992 and 2012. Results: The patients ages are 1 to 97 (mean 64 years) with sex ratio (M/F: 0.95).The distribution by the French American British (FAB) types was RC: 46.3%, RARS: 2.6%, RAEB: 48.7% and CCML: 2.5%. The World Health Organization (WHO-2016) classification takes into account cytological criteria of blood and bone marrow and karyotype (MDSSLD: 3%, MDS-RS: 8%, MDS-MLD: 30%, MDS-EB1: 14%, MDS-EB2: 25%, MDS with isolated del (5q): 11%, MDS unclassifiable: 5% and MDS/MPS: 4%). Conclusion: The aims of WHO classifications were to more specify minimal criteria for MDS diagnosis, to separate MDS from other myeloid malignancies and to define the most homogenous subgroups for morphological aspect and also in terms of response to new treatments.