[Birgitta-A]

Hi sbk007,
As far as I understand the suppl of Leukemia Research with the abstracts is free.

Here is another interesting abstact about hypocellularity:

Hypoplastic myelodysplastic syndromes are not a specific clinical entity
J. Schemenau, S.E. Baldus, M. Anlauf et al
Department of Hematology and Oncology, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany

Background:
About 10-15% of all Myelodysplastic syndromes (MDS) present with hypocelluar bone marrow, but data on haematological characteristics and clinicial outcome are sparse.

Introduction:
Recently, Tong et al proposed a special prognostic scoring system for patients with MDS and hypocellular marrow.

Purpose:
The aim of our study was to describe haematological, cytogenetic, clinical, and prognostic characteristics of patients with hypocellular MDS using the data base of the Düsseldorf registry.

Materials and Methods:
We analysed data of 3742 patients, in which cellularity was assessed by means of central cytology and/or histology.

Patients characteristics at the time of diagnosis were compared between hypercellular (N=1686), normocellular (n=1580) and hypocellular (n=476) cases.

Prognostic parameters used in the IPSS as well as in the prognostic score for hypoplastic MDS were analysed. Patients were followed up until December 31th 2012.

Results:
There were no significant differences with regard to age, gender, haematological features, such as haemoglobin between hyper-, normo- and hypocellular cases (p=n.s.), whereas a significant difference in platelet levels between hypo- and normocellular MDS (p=0,005) and ANC levels between hypocellular compared to normo and hypercellular MDS (p=0,001) could be found.

Differences with regard to cytogenetic risk groups, LDH, IPSS-,WPSS and IPSS-R risk groups, bonemarrow blasts and general health condition could not be described (all p values n. s.), except for WHO Types (p=0,005).

Median survival of the hypercellular cases was 20 months, as compared to 32 months in the normo-, and 29 months in the hypocellular cases (p=0,0005).

The cumulative risk of AML evolution 2 and 5 years after diagnosis was comparable 29%, 20%, 25% after 2 years, 44%, 37%, 45% after 5 years (p=0,003).

The risk groups defined by the recently published hypocellular prognostic score (Tong et al, Cancer 2012) differed in terms of prognosis, but the capacity of the score to subdivide the patients was even higher when applied to normo- and hypercellular cases. The low risk group of hypercellular patients had a worse prognosis as compared to normo- and hypocellular patients.

Conclusions:
Patients with hypocellular MDS did not differ significantly from hyper- and normocellular types with regard to haematopoietic insufficiency and prognosis and therefore should not define a separate MDS type. As the prognostic parameters did not differ, the hypocellular score is working fine, but is not specific. These cases can be prognosticated using the IPSS with the same results as compared to other MDS cases.
Kind regards
Birgitta-A