Introduction

Myelodysplastic syndromes (MDS) are clonal disorders characterized, initially, by ineffective hematopoiesis and, subsequently, by frequent development of acute myeloid leukemia (AML). Peripheral blood cytopenias, in combination with a hypercellular bone marrow exhibiting dysplastic changes, are the hallmarks of MDS. In 1982, the French-American-British (FAB) Cooperative Group classified five subentities of MDS: refractory anemia (RA), refractory anemia with excess of blasts (RAEB), refractory anemia with excess of blasts in transformation (RAEB-T), refractory anemia with ringed sideroblasts (RARS), and chronic myelo-monocytic leukemia (CMML). This classification based on morphological criteria was recently revised, resulting in the World Health Organization (WHO) classification that includes, in addition, specific chromosomal changes.

In addition to FAB and WHO classifications, the initial chromosomal aberration, the age of patient, and the number and severity of cytopenias are most important to evaluate the prognosis of MDS as summarized in the International Prognostic Scoring System (IPSS). The median survival of MDS patients according to this classification ranges from 6 years for low-risk patients to 6 months for high-risk patients. The value of IPSS for assessing individual prognosis in patients with MDS has been demonstrated in several further studies.

Getting Started With Dumbbells

Getting Started With Dumbbells

The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.

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