Cytogenetics

Several series have reported the prognostic impact on survival and leukemic risk of several types of marrow chromosomal abnormalities, although only recently has this variable been shown to have independent prognostic value.8-11 Sequential cytogenetic studies are valuable tools during follow-up.1213 The appearance of chromosomal abnormalities in a patient with a previously normal karyotype or the emergence of additional aberrations is associated with disease progression and shorter survival. This finding may be of particular value in patients with RA and RA with ringed sideroblasts (RARS). However, it should be stressed that chromosomal stability does not preclude the development of AML. In fact, the majority of MDS patients do not show chromosomal changes at the time of acute leukemic transformation.3^13

Table 43.2 Prognostic factors identified in patients with MDS

Characteristic Unfavorable value

Table 43.2 Prognostic factors identified in patients with MDS

Characteristic Unfavorable value

Clinical

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