Recent Advances in Myelodysplastic Syndromes

of risk. This importance is particularly stressed if the prognostic variability and aggressive nature of the currently available curative treatment options is taken into account, especially when considering the advanced age of the majority of patients. Although the French-American-British (FAB) classification has been relatively effective for categorizing MDS patients since 1982,1 its limitations have become evident. These limitations include the wide range of marrow blast percentages for patients in the refractory anemia with excess of blasts (RAEB) and chronic myelomonocytic leukemia (CMML) categories (520%, 1-20%, respectively), lack of inclusion of critical biological determinants such as marrow cytogenetics, and the degree and number of morbidity-associated cytopenias. These well-perceived problems for categorization of MDS patients have led to the development of numerous additional risk-based stratification systems. This review summarizes our knowledge of the prognostic factors in MDS, and critically analyzes the usefulness and limitations of recently developed prognostic models for MDS. Prognostic factors in some particular settings of patients and associated with certain treatment approaches will also be discussed.