Background:
Myelodysplastic syndrome(MDS) is a primary hematologic disorder
characterized by ineffective bone marrow hematopoiesis with peripheral pancytopenia and
aberrant cellular development. For its various subtypes and clinical courses, it is
important to evaluate the prognostic factors of MDS at diagnosis.
Methods:
Medical records were reviewed and analysis was done to the 20 cases of
MDS among in-patients of the hemato-oncology department at Guro Hospital from
January 1990 to December 1994, for the evaluation of clinical courses and prognostic
factors based on the score systems such as Bournemouth, Sanz and Gattermann score,
and bone marrow fibrosis.
Results:
1) The age incidence was mainly distributed on the 2nd-5th decades(85%), and male
to female ratio was 13 : 7.
2) The most common symptom was exertional dyspnea, followed by generalized
weakness, easy brushing, dizziness and febrile sensation and the most common physical
finding was pallor followed by purpura, hepatosplenomegaly and lymphadenopathy.
3) The most common subtype was RA(40%), followed by RAEB(25%), RARS(20%)
and RAEBT(15%) and the scores of Bournemouth Sanz and Gattermann at the patients
with RAEB and RAEBT were significantly higher than those at the patients with RA
and RARS(p<0.05).
4) Bone marrow fibrosis was found in 8 cases, and the scores of these cases were
higher than those without bone marrow fibrosis, and statistically significant difference
(p<0.05) in Gattermann score between these two groups was observed.
5) The conversion to AML was seen in 4 cases with group C of Gattermann score
and bone marrow fibrosis was found in 3 cases.
Conclusion:
The scores of Bournemouth, Sanz and Gattermann were useful in
evaluating the prognosis of MDS, but Gattermann score was more valuable than those
of Bournemouth and Sanz to predict the prognosis of MDS, and bone marrow fibrosis
may be associated with bad prognosis. The more extensive study will be reqired to confirm these findings.

Keywords: Myelodysplastic syndrome, Score system, Bone marrow fibrosis, Prognostic factor