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Lecture 12-Myelodysplastic syndrome_SFSU_Lu.pdf

Lecture 12-Myelodysplastic syndrome_SFSU_Lu.pdf -...

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Myelodysplastic Syndrome (MDS) Chuanyi Mark Lu, MD PhD Faculty, Department of Biology, SFSU Professor, Department of Laboratory Medicine, UCSF Hematopathologist, UCSFMC and SF VAMC
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MDS Overview Diagnosis & classification - Morphologic features - Classification (FAB, WHO- 1999 & 2008) - Cytogenetics - Outcome prediction (IPSS 1997 and IPSS-R 2012) Management overview
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Overview: definition, prevalence, incidence Acquired and heterogeneous group of myeloid malignancies characterized by clonal hematopoiesis, impaired differentiation, peripheral cytopenias, and risk of progression of AML The most common hematologic malignancy in the population older than 60 Mostly seen in the elderly (median age is 70) (affect 1 in every 500 persons in the population older than 60) and in individuals with prior exposure to cytotoxic therapy 10,000-12,000 new cases annually in the U.S. (25-40 cases per 10 5 per year in older population; 3-4 per 10 5 in general population)
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MDS: Pathogenesis
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Overview: mostly idiopathic identifiable causes (seen in only ~15% of cases) Antineoplastic agents Alkylating agents : Busulfan, Carboplatin, Carmustine, Chlorambucil, Cisplatin, Cyclophosphamide, Dacarbazine, Lomustine, Melphalan, etc. Topoisomerase II inhibitors : Daunorubicin, Doxorubicin, Etoposide, Mitoxantrone, Razoxane, etc. Purine analogues : Fludarabine and others Radiotherapy Environmental factors Tobacco Ionizing radiation Benzene exposure (and industrial hydrocarbons) Agricultural compounds (pesticides, herbicides, fertilizers)
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