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Old Sun Nov 4, 2007, 05:12 AM
Birgitta-A Birgitta-A is offline
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Join Date: Oct 2007
Location: Stockholm, Sweden
Posts: 1,918
Thumbs up Criteria to diagnose MDS

Hi Wattle,
Many members have alredy told you that you have to ask for the results from the examinations – blood work and all other examinations. You perhaps have to write and ask for a copy of your report with all laboratory results etc. No doctor can ignore a written inquiry of information.

There are special criteria that have to be fulfilled to diagnose MDS. Here is short info from page 35 in a long article:

Minimal Diagnostic Criteria in MDS
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A. Prerequisite Criteria
- Constant cytopenia (few cells) in one or more of the following cell lineages: erythroid (hemoglobin <11 g/dL); neutrophilic (a kind of white blood cells) (ANC < 1,500/µL) or megakaryocytic (platelets <100,000/µL)
- Exclusion of all other hematopoietic or non-hematopoietic disorders as primary reason for cytopenia/dysplasia

B. MDS-related (Decisive) Criteria
- Dysplasia in at least 10% of all cells in one of the follwing lineages in the bone marrow smear: erythroid; neutrophilic; or megakaryocytic or >15% ringed sideroblasts (iron stain)
- 5-19% blast cells in bone marrow smears
- Typical chromosomal abnormality (by conventional karyotyping or FISH)

C. Co-criteria (for patients fulfilling A but not B, and otherwise show typical clinical features, e.g. macrocytic transfusion-dependent anemia)
- Abnormal phenotype of bone marrow cells clearly indicative of a monoclonal
population of erythroid or/and myeloid cells, determined by flow cytometry
- Clear molecular signs of a monoclonal cell population in HUMARA assay,
gene chip profiling, or point mutation analysis (e.g. RAS mutations)
- Markedly and persistently reduced colony-formation (+/- cluster formation) of bone marrow or/and circulating progenitor cells (CFU-assay)
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I have understood that your hemoglobin was 131 but you have not written anything about the white blood cells (and specially the neutrophilic white blood cells) ot the platelets. If the neutrophilic white blood cells and the platelets are OK then you don´t fulfil the prerequisite criteria for MDS.

This article is long but very important for MDS patients:
http://www.hematologics.com/pdf/ref36.pdf

You can mail to me if you want to get an explanation of difficult words.
Kind regards
Birgitta
68 yo, MDS intermideate-1 dx May 2006, transfusion dependent, Neupogen 2 injections/w, Prednisolone 5 mg/day.
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