4.3 Review

Advances in myelodysplastic/myeloproliferative neoplasms

Journal

VIRCHOWS ARCHIV
Volume 482, Issue 1, Pages 69-83

Publisher

SPRINGER
DOI: 10.1007/s00428-022-03465-7

Keywords

Myelodysplastic/myeloproliferative neoplasms; Chronic myelomonocytic leukemia; Atypical chronic myeloid leukemia; Myelodysplastic/myeloproliferative neoplasm with SF3B1 mutation and thrombocytosis; Myelodysplastic/myeloproliferative neoplasm with isolated i(17q)

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The MDS/MPN category includes diseases with both myelodysplastic and myeloproliferative features. The revised International Consensus Classification now requires the presence of increased peripheral blood cell counts and concomitant cytopenia for diagnosis. The use of modern gene sequencing has improved understanding of the biological characteristics and specific mutations of these diseases, which are now included in the diagnostic criteria for some MDS/MPN entities. This review highlights the changes in diagnostic criteria and provides practical guidance for diagnosis.
The myelodysplastic syndrome/myeloproliferative neoplasms (MDS/MPN) category includes a heterogeneous group of diseases characterized by the co-occurrence of clinical and pathologic features of both myelodysplastic and myeloproliferative neoplasms. The recently published International Consensus Classification of myeloid neoplasms revised the entities included in the MDS/MPN category as well as criteria for their diagnosis. In addition to the presence of one or more increased peripheral blood cell counts as evidence of myeloproliferative features, concomitant cytopenia as evidence of ineffective hematopoiesis is now an explicit requirement to diagnose the diseases included in this category. The increasing availability of modern gene sequencing has allowed better understanding of the biologic characteristics of these myeloid neoplasms. The presence of specific mutations in the appropriate clinicopathologic context is now included in the diagnostic criteria for some of MDS/MPN entities. In this review, we highlight what has changed in the diagnostic criteria of MDS/MPN from the WHO 2016 classification while providing practical guidance in diagnosing these diseases.

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