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MDS staging is performed differently than the staging for any other type of cancer. That’s because traditional staging systems are based on the size and extent of a solid tumor; myelodysplastic syndromes develop in the bone marrow and do not produce solid tumors that can be assessed in the conventional ways.
To address this, physicians developed the International Prognostic Scoring System (IPSS) as a way to stage myelodysplastic syndromes. This MDS staging system takes into account the following factors: the percentage of blasts (immature blood cells) in the bone marrow, the presence and type of chromosomal abnormalities in the cells and The patient’s red blood cell, white blood cell and platelet counts. Each of these factors is assigned a score. The three scores are then added together, and the final score is used to classify a patient into one of the following four categories:
- Very low risk
- Low risk
- Intermediate 1 risk
- High risk
Sometimes, patients are assigned a risk category based on their MDS subtype, their chromosomal abnormalities and whether or not they require blood transfusions. However, this system, which was recently developed by the World Health Organization, is less widely used than the IPSS.
In addition, we compliment this staging system by data from sophisticated molecular testing for somatic gene mutations in MDS “ gene mis-happenings in the blood cells” which are known to be prognostic and can sometimes be targeted with newer treatments or clinical trials. Moffitt Cancer Center’s team of expert oncologists typically stages a patient at the point of his or her diagnosis and then uses this information to tailor a treatment recommendation to the patient’s specific needs. We also use MDS staging to determine the likelihood that a patient’s myelodysplastic syndrome will progress into leukemia; this can help us create a long-term plan for detecting unusual changes as soon as they occur.
Medically reviewed by Andrew Kuykendall, MD, Malignant Hematology.