Question about the IPSS-R
 

In everything I have read about the IPSS-R, the “Very Good” category for cytogenetic abnormality list “-Y and del(11q). Also the “Good” category list “Normal, del(5q), del(12p), del(20q), double incl. del(5q)” My question is why isn’t “Normal” under the very good category? It would seem like “Normal” would be the best there is.

Thanks!!

Data

It may seem counterintuitive, but normal genetics isn't as good as certain abnormal genetic findings with you look at the data on MDS patients. If you have MDS, the genetic abnormalities called -Y and del(11q), in the absence of other abnormalities, have been associated with a better prognosis than the finding that there are no abnormalities at all.

I'm sorry to use a contrived example, but consider basketball playing. A person of normal height would have an advantage over a person of short stature (abnormal height), but a person who is abnormally tall would have an advantage for this one skill. Their abnormality might lead to problems in other areas (e.g., skeletal problems) but its still statistically correlated with a better outcome in basketball playing.

Loss of a Y chromosome applies only to men, since Y is the male sex chromosome, and its frequency increases with age. Unfortunately, deletion of chromosome 11 is rather uncommon for MDS patients.

Thanks
 

Neil,
Thanks for the information. I guess that is like a lot of other things with bone marrow diseases - they don't make sense but we have to accept them. I go back next week to get the results of my third bone marrow biopsy and the opinion of "2nd opinion doc".

Thanks again

Data