Journal of Clinical Oncology, 2008 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 26, No 15S (May 20 Supplement), 2008: 6628
© 2008 American Society of Clinical Oncology

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Abstract

Classification of myelodysplastic syndrome in a national registry of recently-diagnosed patients—the Patient Registries at Slone: MDS

Boston University, Boston, MA; Dana-Farber Cancer Institute, Boston, MA

6628

Background: The WHO classification system for myelodysplastic syndrome (MDS) includes more extensive morphologic and cytogenetic criteria important for prognosis and treatment than the older FAB scheme (e.g., 5q-), but it is not known to what extent the WHO scheme has been adopted by practicing hematologists and pathologists. Methods: The Patient Registries at Slone: MDS is a national disease-based observational registry maintained at Boston University. All patients with MDS diagnosed within 4 months of enrollment are eligible for inclusion; subjects enroll by mail or over the Internet. For this analysis, we reviewed the medical records of enrollees from June 2006 through December 2007 to determine which classification scheme was used and by whom (hematologists or pathologists). Results: Records were available for 127 patients, representing 38 states (46% male; median age 64). MDS classification was as follows: No clear association with documentation of MDS or subtype was seen for age, geographic region, education, race, or prescription drug coverage. Patients with a documented MDS diagnosis were more likely to be treated than those whose diagnosis was not documented (74% vs. 47%; p=0.04). Conclusions: For patients with documented MDS, clear WHO subtypes are recorded 39% of the time, compared to 8% for FAB subtypes; this finding from our national cohort bodes well for increasing consistency between MDS researchers and caregivers. The finding that 13% of patients who believe they have MDS have no documentation of the disease may reflect doctors raising this possibility before confirming the diagnosis. Many fewer pathologists than hematologists document MDS in their reports, which may be due to differential application of diagnostic criteria.

Abstract presentation from the 2008 ASCO Annual Meeting