{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:12:56Z","timestamp":1740147176404,"version":"3.37.3"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T00:00:00Z","timestamp":1538697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Diagnosis of myelodysplastic syndromes (<jats:styled-content style=\"fixed-case\">MDS<\/jats:styled-content>s) when anemia is the only abnormality can be complicated. The aim of our study was to investigate the primary causes of anemia and\/or macrocytosis of uncertain etiology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a multicenter, prospective study over 4\u00a0months in three hematology laboratories. In step 1, we used an automated informatics system to screen 137\u00a0453 hemograms for cases of anemia and\/or macrocytosis (n\u00a0=\u00a02702). In step 2, we excluded all patients whose anemia appeared to be due to a known cause. This left 290 patients had anemia of uncertain etiology. In step 3, we conducted further investigations, including a peripheral blood smear, and analysis of iron, vitamin B12, folate, and thyroid hormone levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A differential diagnosis was obtained in 139 patients (48%). The primary causes of anemia were iron deficiency (n\u00a0=\u00a059) and megaloblastic anemia (n\u00a0=\u00a039). In total, 25 hematologic disorders were diagnosed, including 14 patients with <jats:styled-content style=\"fixed-case\">MDS<\/jats:styled-content> (56%). The median age of <jats:styled-content style=\"fixed-case\">MDS<\/jats:styled-content> patients was 80\u00a0years, 12 had anemia as an isolated cytopenia, and most (n\u00a0=\u00a010) had lower\u2010risk disease (<jats:styled-content style=\"fixed-case\">IPSS<\/jats:styled-content>\u2010R\u00a0\u2264\u00a03.5). <jats:italic><jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content>3B1<\/jats:italic> mutations were most frequent (n\u00a0=\u00a06) and correlated with the presence of ring sideroblasts (100%) and associated with better prognosis (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our prospective, four\u2010step approach is an efficient and logical strategy to facilitate the diagnosis of <jats:styled-content style=\"fixed-case\">MDS<\/jats:styled-content> on the basis of unexplained anemia and\/or macrocytosis, and may allow the early diagnosis of the most serious causes of anemia. Molecular analysis of genes related to <jats:styled-content style=\"fixed-case\">MDS<\/jats:styled-content> could be a promising diagnostic and prognostic approach.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijlh.12933","type":"journal-article","created":{"date-parts":[[2018,10,6]],"date-time":"2018-10-06T09:55:11Z","timestamp":1538819711000},"page":"109-117","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hidden myelodysplastic syndrome (MDS): A prospective study to confirm or exclude <scp>MDS<\/scp> in patients with anemia of uncertain etiology"],"prefix":"10.1111","volume":"41","author":[{"given":"Jos\u00e9 Mar\u00eda","family":"Bastida","sequence":"first","affiliation":[{"name":"Hematology Hospital Universitario de Salamanca\u2010IBSAL  Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oriana","family":"L\u00f3pez\u2010Godino","sequence":"additional","affiliation":[{"name":"Hematology Hospital Universitario de Salamanca\u2010IBSAL  Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Vicente\u2010S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Hematology Hospital de la Ribera  Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santiago","family":"Bonanad\u2010Boix","sequence":"additional","affiliation":[{"name":"Hematology Hospital de la Ribera  Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blanca","family":"Xicoy\u2010Cirici","sequence":"additional","affiliation":[{"name":"Institut Catal\u00e0 d'Oncologia Hospital Germans Trias i Pujol Josep Carreras Leukemia Research Institute  Badalona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesus M.","family":"Hern\u00e1ndez\u2010S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Instituto de Investigacion Biomedica de Salamanca IBMCC Centro de Investigacion del Cancer Universidad de Salamanca\u2010CSIC  Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esperanza","family":"Such","sequence":"additional","affiliation":[{"name":"Hematology Laboratorio de Citogen\u00e9tica y Biolog\u00eda Molecular Hospital Universitari i Polit\u00e8cnic La Fe  Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Cervera","sequence":"additional","affiliation":[{"name":"Hematology Laboratorio de Citogen\u00e9tica y Biolog\u00eda Molecular Hospital Universitari i Polit\u00e8cnic La Fe  Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan C.","family":"Caballero\u2010Berrocal","sequence":"additional","affiliation":[{"name":"Hematology Hospital Universitario de Salamanca\u2010IBSAL  Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e9lix","family":"L\u00f3pez\u2010Cadenas","sequence":"additional","affiliation":[{"name":"Hematology Hospital Universitario de Salamanca\u2010IBSAL  Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Arnao\u2010Herr\u00e1iz","sequence":"additional","affiliation":[{"name":"Hematology Hospital de la Ribera  Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u00e9s","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Institut Catal\u00e0 d'Oncologia Hospital Germans Trias i Pujol Josep Carreras Leukemia Research Institute  Badalona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inmaculada","family":"Llopis\u2010Calatayud","sequence":"additional","affiliation":[{"name":"Hematology Hospital de la Ribera  Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda J.","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Institut Catal\u00e0 d'Oncologia Hospital Germans Trias i Pujol Josep Carreras Leukemia Research Institute  Badalona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Consuelo","family":"del Ca\u00f1izo\u2010Rold\u00e1n","sequence":"additional","affiliation":[{"name":"Hematology Hospital Universitario de Salamanca\u2010IBSAL  Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1467-6779","authenticated-orcid":false,"given":"Maria","family":"D\u00edez\u2010Campelo","sequence":"additional","affiliation":[{"name":"Hematology Hospital Universitario de Salamanca\u2010IBSAL  Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,5]]},"reference":[{"volume-title":"Haemoglobin Concentration for the Diagnosis of Anaemia and Assessment of severity. 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