{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:02:47Z","timestamp":1792274567565,"version":"4.4.0"},"reference-count":23,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"27","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2016,9,20]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>WHO classification of myeloid malignancies is based mainly on the percentage of bone marrow (BM) blasts. This is considered from total nucleated cells (TNCs), unless there is erythroid-hyperplasia (erythroblasts \u2265 50%), calculated from nonerythroid cells (NECs). In these instances, when BM blasts are \u2265 20%, the disorder is classified as erythroleukemia, and when BM blasts are &lt; 20%, as myelodysplastic syndrome (MDS). In the latter, the percentage of blasts is considered from TNCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We assessed the percentage of BM blasts from TNCs and NECs in 3,692 patients with MDS from the Grupo Espa\u00f1ol de S\u00edndromes Mielodispl\u00e1sicos, 465 patients with erythroid hyperplasia (MDS-E) and 3,227 patients without erythroid hyperplasia. We evaluated the relevance of both quantifications on classification and prognostication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>By enumerating blasts systematically from NECs, 22% of patients with MDS-E and 12% with MDS from the whole series diagnosed within WHO categories with &lt; 5% BM blasts, were reclassified into higher-risk categories and showed a poorer overall survival than did those who remained in initial categories (P = .006 and P = .001, respectively). Following WHO recommendations, refractory anemia with excess blasts (RAEB)-2 diagnosis is not possible in MDS-E, as patients with 10% to &lt; 20% BM blasts from TNCs fulfill erythroleukemia criteria; however, by considering blasts from NECs, 72 patients were recoded as RAEB-2 and showed an inferior overall survival than did patients with RAEB-1 without erythroid hyperplasia. Recalculating the International Prognostic Scoring System by enumerating blasts from NECs in MDS-E and in the overall MDS population reclassified approximately 9% of lower-risk patients into higher-risk categories, which indicated the survival expected for higher-risk patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Regardless of the presence of erythroid hyperplasia, calculating the percentage of BM blasts from NECs improves prognostic assessment of MDS. This fact should be considered in future WHO classification reviews.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.2016.66.9705","type":"journal-article","created":{"date-parts":[[2016,7,5]],"date-time":"2016-07-05T23:08:48Z","timestamp":1467760128000},"page":"3284-3292","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":20,"title":["Considering Bone Marrow Blasts From Nonerythroid Cellularity Improves the Prognostic Evaluation of Myelodysplastic Syndromes"],"prefix":"10.1200","volume":"34","author":[{"given":"Leonor","family":"Arenillas","sequence":"first","affiliation":[{"name":"Leonor Arenillas, Xavier Calvo, Carme Pedro, Ana Ferrer, and Lourdes Florensa, Hospital del Mar Research Institute; Esther Alonso, Hospital Universitario Bellvitge Hospitalet de Llobregat; Julia Montoro, Hospital Universitario Vall d' Hebron; Salut Brunet, Hospital Santa Creu i Sant Pau; Benet Nomdedeu, Hospital Cl\u00ednic, Barcelona; Elisa Lu\u00f1o, Hospital Universitario Central Asturias, Oviedo; Leonor Senent and Guillermo F. Sanz, Hospital Universitario La Fe; Mar Tormo, Hospital Cl\u00ednico Universitario de..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Calvo","sequence":"additional","affiliation":[{"name":"Leonor Arenillas, Xavier Calvo, Carme Pedro, Ana Ferrer, and Lourdes Florensa, Hospital del Mar Research Institute; Esther Alonso, Hospital Universitario Bellvitge Hospitalet de Llobregat; Julia Montoro, Hospital Universitario Vall d' Hebron; Salut Brunet, Hospital Santa Creu i Sant Pau; Benet Nomdedeu, Hospital Cl\u00ednic, Barcelona; Elisa Lu\u00f1o, Hospital Universitario Central Asturias, Oviedo; Leonor Senent and Guillermo F. Sanz, Hospital Universitario La Fe; Mar Tormo, Hospital Cl\u00ednico Universitario de..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Lu\u00f1o","sequence":"additional","affiliation":[{"name":"Leonor Arenillas, Xavier Calvo, Carme Pedro, Ana Ferrer, and Lourdes Florensa, Hospital del Mar Research Institute; Esther Alonso, Hospital Universitario Bellvitge Hospitalet de Llobregat; Julia Montoro, Hospital Universitario Vall d' Hebron; Salut Brunet, Hospital Santa Creu i Sant Pau; Benet Nomdedeu, Hospital Cl\u00ednic, Barcelona; Elisa Lu\u00f1o, Hospital Universitario Central Asturias, Oviedo; Leonor Senent and Guillermo F. Sanz, Hospital Universitario La Fe; Mar Tormo, Hospital Cl\u00ednico Universitario de..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonor","family":"Senent","sequence":"additional","affiliation":[{"name":"Leonor Arenillas, Xavier Calvo, Carme Pedro, Ana Ferrer, and Lourdes Florensa, Hospital del Mar Research Institute; Esther Alonso, Hospital Universitario Bellvitge Hospitalet de Llobregat; Julia Montoro, Hospital Universitario Vall d' Hebron; Salut Brunet, Hospital Santa Creu i Sant Pau; Benet Nomdedeu, Hospital Cl\u00ednic, Barcelona; Elisa Lu\u00f1o, Hospital Universitario Central Asturias, Oviedo; Leonor Senent and Guillermo F. Sanz, Hospital Universitario La Fe; Mar Tormo, Hospital Cl\u00ednico Universitario de..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Alonso","sequence":"additional","affiliation":[{"name":"Leonor Arenillas, Xavier Calvo, Carme Pedro, Ana Ferrer, and Lourdes Florensa, Hospital del Mar Research Institute; Esther Alonso, Hospital Universitario Bellvitge Hospitalet de Llobregat; Julia Montoro, Hospital Universitario Vall d' Hebron; Salut Brunet, Hospital Santa Creu i Sant Pau; Benet Nomdedeu, Hospital Cl\u00ednic, Barcelona; Elisa Lu\u00f1o, Hospital Universitario Central Asturias, Oviedo; Leonor Senent and Guillermo F. Sanz, Hospital Universitario La Fe; Mar Tormo, Hospital Cl\u00ednico Universitario de..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Ramos","sequence":"additional","affiliation":[{"name":"Leonor Arenillas, Xavier Calvo, Carme Pedro, Ana Ferrer, and Lourdes Florensa, Hospital del Mar Research Institute; Esther Alonso, Hospital Universitario Bellvitge Hospitalet de Llobregat; Julia Montoro, Hospital Universitario Vall d' Hebron; Salut Brunet, Hospital Santa Creu i Sant Pau; Benet Nomdedeu, Hospital Cl\u00ednic, Barcelona; Elisa Lu\u00f1o, Hospital Universitario Central Asturias, Oviedo; Leonor Senent and Guillermo F. Sanz, Hospital Universitario La Fe; Mar Tormo, Hospital Cl\u00ednico Universitario de..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Teresa","family":"Ardanaz","sequence":"additional","affiliation":[{"name":"Leonor Arenillas, Xavier Calvo, Carme Pedro, Ana Ferrer, and Lourdes Florensa, Hospital del Mar Research Institute; Esther Alonso, Hospital Universitario Bellvitge Hospitalet de Llobregat; Julia Montoro, Hospital Universitario Vall d' Hebron; Salut Brunet, Hospital Santa Creu i Sant Pau; Benet Nomdedeu, Hospital Cl\u00ednic, Barcelona; Elisa Lu\u00f1o, Hospital Universitario Central Asturias, Oviedo; Leonor Senent and Guillermo F. Sanz, Hospital Universitario La Fe; Mar Tormo, Hospital Cl\u00ednico Universitario de..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carme","family":"Pedro","sequence":"additional","affiliation":[{"name":"Leonor Arenillas, Xavier Calvo, Carme Pedro, Ana Ferrer, and Lourdes Florensa, Hospital del Mar Research Institute; Esther Alonso, Hospital Universitario Bellvitge Hospitalet de Llobregat; Julia Montoro, Hospital Universitario Vall d' Hebron; Salut Brunet, Hospital Santa Creu i Sant Pau; Benet Nomdedeu, Hospital Cl\u00ednic, Barcelona; Elisa Lu\u00f1o, Hospital Universitario Central Asturias, Oviedo; Leonor Senent and Guillermo F. 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