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Curr Opin Oncol. 2002 Jan;14(1):19-23.

Proposed changes in the definitions of acute myeloid leukemia and myelodysplastic syndrome: are they helpful?

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  • 1Department of Pathology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-5310, USA.


For most of the 20th century, subclassification of acute myeloid leukemia (AML) was based on the resemblance of blasts to normal hematopoiesis. This approach was standardized by the French-American-British (FAB) group. Because of limited clinical relevance, clinicians resorted to other patient characteristics to determine treatment and predict outcome in AML. A different approach based on the relationship of a case to myelodysplastic syndrome (MDS) has been proposed. The new World Health Organization (WHO) subclassification of AML includes elements of this new proposal but retains as a major category the historical subclassification. The WHO group has also proposed modifications of the FAB subclassification of MDS. These MDS proposals have generated discussion of diagnostic criteria for MDS and a philosophical discussion of whether MDS should still be considered a syndrome, or rather a specific set of diseases characterized by genetic instability and poor outcome.

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