The cancer dataset anylyzed involves Myelodysplastic Syndromes
(MDS). MDS is a clinical descriptor of a heterogeneous group
of clonal hematopoietic disorders (see Figure 2). These malignancies
are characterized by: refractory peripheral blood cytopenia
(due to a cellular marrow- and hence ineffective blood production),
morphologically evident dysplasia, and possible transformation
into chemotherapy-resistant acute myeloid leukemia (AML).
MDS is relatively common hematological disease (Aul, Gatterman
et al. 1992) with a prevalence of 22-45 per 105 people in
the elderly (over 70), putting it in the same level as chronic
lymphocytic leukemia (CLL) and multiple myeloma (MM).
Classification systems have been developed based on bone marrow
(BM) morphology [e.g. the French-American-British (FAB) Cooperative
Group system (Bennett & Catovsky, 1982)]. FAB breaks down
MDS into five subcategories: refractory anemia (RA), refractory
anemia with ringed sideroblasts (RARS), refractory anemia
with excess blasts (RAEB), refractory anemia with excess blasts
in transformation (RAEB-T), and chronic myelomonocytic leukemia
(CMML). Early diagnosis is complicated by the fact that initial
symptoms may only include fatigue (due to anemia) and can
overlap with other diseases. Separating MDS from other cytopenic
entities such as Philadelphia chromosome-negative chronic
myelocytic leukemia (CML) and myeloproliferative disorders
(MPD) can sometimes be tricky as well (Hoffman 2000).
| Bone Marrow* |
Description |
 |
Normal Bone marrow smear, May-Giemsa stain, x100 |
 |
Refractory Anemia (RA)
Bone marrow smear, May-Giemsa stain, x200 |
 |
Refractory Anemia with Ringed Sideroblasts (RARS)
Bone marrow smear, Iron stain, x1000 |
 |
Refractory Anemia with Excess of Blasts in
transformation (RAEB-t)
Bone marrow smear, May-Giemsa stain, x200 |
| |
|
References
1. C. Aul, N. Gatterman, and W. Schneider, "Age-related
incidence and other epidemiological aspects of myelodysplastic
syndrome," Br J Haematol, vol. 82, 1992.
2. J. Bennett, D. Catovsky, T. Daniel, and e. al, "FAB
Cooperative Group: Proposal for the classification of the
myelodysplastic syndromes," Br J Haematol, vol. 51, 1982.
3. Hoffman, Hematology: Basic Principles and Practice, 3rd
ed: Churchill Livingstone, Inc., 2000.
* Source: Atlas of Hematology , Nagoya University School
of Medicine , 1996