Yu Ming-hua, Liu Shi-he, Shao Ying-qi, Hao Yu-shu, Xiao Zhi-jian
Institute of Hematology, CAMS & PUMC, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2004 Aug;25(8):482-5.
To compare the results of cytogenetic and IPSS grouping of primary myelodysplastic syndromes (pMDS) patients classified by FAB- or WHO classification.
Two hundred and thirty seven cases of pMDS who were previously classified according to FAB criteria were reclassified with WHO classification. A comparison was made between the results of the two classifications.
For the detection rates of cytogenetic abnormality and its risks group, there was no difference among the FAB subgroups but the detection rate was different between the WHO refractory cytopenia with multilineage dysplasia (RCMD) and RA subgroups (74.4% and 42.5%, respectively) (P < 0.001). The percentage of good karyotype abnormalities in RA (65.0%) was higher than that in RCMD (24.4%) (P < 0.001), and the percentages of intermediate and poor karyotype abnormalities in RCMD (48.9% and 26.7%, respectively) were higher than that in RA (27.5% and 7.5%, respectively) (P < 0.05). There was a good correlation between the subgroups and IPSS risk groups for both the WHO classification and the FAB classification, but the WHO classification further reflected the differences between RCMD and RA and RAEB-I and RAEB-II subgroups. The percentage of low-risk group in RCMD (1.1%) was lower than that in RA (10.0%) (P < 0.05), and the percentage of high-risk group in RAEB-II (30.5%) was higher than that in RAEB-I(0) (P < 0.001).
For the correlation between subgroups and cytogenetic abnormalities and IPSS risk groups, the WHO-classification is better than the FAB-classification.
比较根据FAB或WHO分类法分类的原发性骨髓增生异常综合征(pMDS)患者的细胞遗传学和国际预后评分系统(IPSS)分组结果。
对237例先前根据FAB标准分类的pMDS病例进行WHO分类重新分类。对两种分类结果进行比较。
对于细胞遗传学异常及其风险组的检出率,FAB亚组之间无差异,但WHO的难治性血细胞减少伴多系发育异常(RCMD)和难治性贫血(RA)亚组之间的检出率不同(分别为74.4%和42.5%)(P<0.001)。RA中良好核型异常的百分比(65.0%)高于RCMD(24.4%)(P<0.001),RCMD中中等和不良核型异常的百分比(分别为48.9%和26.7%)高于RA(分别为27.5%和7.5%)(P<0.05)。WHO分类和FAB分类的亚组与IPSS风险组之间均具有良好的相关性,但WHO分类进一步反映了RCMD与RA以及难治性贫血伴原始细胞增多-1(RAEB-I)与难治性贫血伴原始细胞增多-2(RAEB-II)亚组之间的差异。RCMD中低风险组的百分比(1.1%)低于RA(10.0%)(P<0.05),RAEB-II中高风险组的百分比(30.5%)高于RAEB-I(0)(P<0.001)。
对于亚组与细胞遗传学异常及IPSS风险组之间的相关性,WHO分类优于FAB分类。