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MDS Diagnostic Spectrum

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Differentiating between myelodysplastic syndromes, myeloproliferative neoplasms such as primary myelofibrosis, and myelodysplastic syndromes/myeloproliferative neoplasm overlap syndromes can be challenging due to diagnostic similarities among these disorders. While there is some overlap in important risk stratification variables in these chronic myeloid neoplasms, prognostic scoring systems used for individual disorders are distinct. Use this reference card to draw a more clear distinction between the disorders and to help risk-stratify patients.

The card was developed by:

  • Brady L. Stein, MD, MHS, Robert H. Lurie Comprehensive Cancer Center, Northwestern University; Chicago, Illinois
  • David P. Steensma, MD, FACP, Dana-Farber Cancer Institute, Harvard Medical School; Boston, Massachusetts
  • Ruben A. Mesa, MD, FACP, Chair, Division of Hematology & Medical Oncology, Mayo Clinic Arizona; Phoenix and Scottsdale, Arizona



Greenberg P, et al. Revised international prognostic scoring system for myelodysplastic syndromes. Blood. 2012:120(12):2454


Malcovati L et al. Time-dependent prognostic scoring system for predicting survival and leukemic evolution in myelodysplastic syndromes. J Clin Oncol. 2007:25(23):3503.

MD Anderson Cancer Center Risk Model

Kantarjian H et al. Proposal for a new risk model in myelodysplastic syndromes that accounts for events not considered in the original International Prognostic Scoring System. Cancer. 2008:113(6):1351.

CMML and MDS/MPN Overlap

Onida et al. Prognostic factors and scoring systems in chronic myelomonocytic leukemia: a

retrospective analysis of 213 patients. Blood 2002; 99(3): 840-9.

Such et al. Cytogenetic risk stratification in chronic myelomonocytic leukemia. Haematologica 2011; 96(3): 375-83

Liu et al. A Prognostic Scoring System for Unclassifiable MDS and MDS/MPN. ASH abstract 1701. Blood 2012

Takahashi et al. Refined MD Anderson Prognostic Scoring System (MDAPS-R) for Chronic Myelomonocytic Leukemia (CMML). ASH abstract 3797. Blood 2012

Patnaik et al. Survival and Prognosis in World Health Organization Defined Chronic Myelomonocytic Leukemia - A Mayo Clinic Series of 227 Patients. ASH abstract 3790. Blood 2012.



Cervantes et al. New prognostic scoring system for primary myelofibrosis based on a study of the International Working Group for Myelofibrosis Research and Treatment. Blood. 2009 Mar 26;113(13):2895-901.


Passamonti et al. A dynamic prognostic model to predict survival in primary myelofibrosis: a study by the IWG-MRT (International Working Group for Myeloproliferative Neoplasms Research and Treatment). Blood 2010; 115: 1703-1708.

DIPSS plus

Gangat et al. DIPSS plus: a refined Dynamic International Prognostic Scoring System for primary myelofibrosis that incorporates prognostic information from karyotype, platelet count and transfusion status. JCO 2011;29(4): 392.

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