Chang Yoon Hwan
Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea.
Blood Res. 2021 Apr 30;56(S1):S51-S64. doi: 10.5045/br.2021.2021010.
Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal hematological neoplasms characterized by ineffective hematopoiesis, morphologic dysplasia, and cytopenia. MDS overlap syndromes include various disorders, such as myelodysplastic/myeloproliferative neoplasms and hypoplastic MDS with aplastic anemia characteristics. MDS overlap syndromes share the characteristics of other diseases, which make differential diagnoses challenging. Advances in genomic studies have led to the discovery of frequent mutations in MDS and overlap syndromes; however, most of the mutations are not specific for the diagnosis of these diseases. The molecular characteristics of the overlap syndromes usually do not show a just "in-between" form but rather heterogeneous features. Established diagnostic criteria for these diseases based on clinical, morphologic, and laboratory features are still useful when combined with genomic data. It is expected that further studies for MDS and overlap syndromes will place emphasis on the roles of mutations as therapeutic targets and prognostic indicators.
骨髓增生异常综合征(MDS)是一组异质性的克隆性血液肿瘤,其特征为造血无效、形态学发育异常和血细胞减少。MDS重叠综合征包括各种疾病,如骨髓增生异常/骨髓增殖性肿瘤以及具有再生障碍性贫血特征的低增生性MDS。MDS重叠综合征具有其他疾病的特征,这使得鉴别诊断具有挑战性。基因组研究的进展已导致在MDS和重叠综合征中发现频繁的突变;然而,大多数突变并非这些疾病诊断所特有的。重叠综合征的分子特征通常并非呈现一种“中间”形式,而是具有异质性特征。基于临床、形态学和实验室特征建立的这些疾病的诊断标准,在与基因组数据相结合时仍然有用。预计对MDS和重叠综合征的进一步研究将着重于突变作为治疗靶点和预后指标的作用。