Marrowforums.org: MDS Classification

About MDS Classification

MDS is a family of diseases, categorized by doctors and researchers into subtypes according to one or more classification schemes. The most commonly used are the International Prognostic Scoring System (IPSS) and the WHO (World Health Organization) Classification System. The older FAB (French American British) Classification System is still used and still referred to in medical literature. For more information about MDS and its subtypes, see MDS Classification.

You can use the MDS Classification Tool to identify your subtype under each of the three MDS classification schemes. Fill in the information you know from your test results or blood counts and your MDS subtypes will be highlighted. If you don't have the necessary information, you may want to ask for that information and the doctor's explanation of your subtype at your doctor's appointment.

Cautions:

The MDS Classification Tool can help you learn more about your health and identify questions to ask your doctor. Tools like this must not be used to make your own diagnostic or treatment decisions or to replace medical consultations. When your test results, especially blood counts, vary from day to day, you might cross from one subtype to another but your underlying disease is the same.
MDS classification is usually done at time of diagnosis. If your counts later change in response to treatment, calculating your IPSS or WHO/FAB subtypes may be less meaningful.
Some treatment centers use slightly different criteria than those used below, producing slightly different definitions of each MDS subtype.
THIS SOFTWARE IS UNDERGOING BETA TESTING. If you have comments that would help us improve this tool, please contact Marrowforums. Also let us know if you would like help using the MDS Classification Tool. Helping you will also help us improve the tool for other people!

Marrowforums MDS Classification

Fill in the fields below with information from your blood and marrow tests, then look for your MDS classifications at the bottom.

Click the questions to learn more about the factors that affect MDS classification. Watch for messages, explanations, or cautions that appear in red. If your test results are on the border between two choices, try them both to see how that affects your subtype.

If you don't have the information needed to fill out this form, make a list of what you'd like to ask your doctor about your test results so you can learn more about your own condition.

• Where do I get the information to fill in this form?

Blood Findings Ⓘ required for IPSS score Ⓦ required for WHO classification Ⓕ required for FAB classification

Red blood cell count Ⓘ Ⓦ Ⓕ
• What are red blood cells?

HGB less than 10%
HGB of 10% or more
don't know

White blood cell count Ⓘ Ⓦ Ⓕ
• What are white blood cells?

WBC less than 1800/µL
WBC 1800/µL or more
don't know

Platelet count Ⓘ Ⓦ Ⓕ
• What are platelets?

platelet count less than 100,000/µL
platelet count 100,000/µL or more
don't know

Blasts in circulating blood Ⓦ Ⓕ
• What are blasts?

less than 1%
1% to 4%
5% to 19%
more than 19%
don't know

Monocyte count Ⓦ Ⓕ
• What are monocytes?
• What do the units "1 x 10⁹/L" and "1000 x 10⁹/µL" mean?

monocyte count less than 1 x 10⁹/L
monocyte count 1 x 10⁹/L or more
don't know

Auer rods in circulating blood Ⓦ
• What are Auer rods?

no Auer rods present
Auer rods present
don't know

Bone Marrow Findings Ⓘ required for IPSS score Ⓦ required for WHO classification Ⓕ required for FAB classification

Dysplasia in bone marrow Ⓦ Ⓕ
• What does "dysplasia" mean?

Check all that apply.

You must have at least one cell line with dysplasia to have WHO and FAB subtypes.

immature red blood cells show dysplasia
immature white blood cells show dysplasia
immature platelet cells show dysplasia

Blasts in bone marrow Ⓘ Ⓦ Ⓕ
• What are blasts?
• How are blasts measured?

less than 5%
5% to 9%
10%
11% to 19%
20%
21% to 30%
more than 30%
don't know

Auer rods in bone marrow Ⓦ
• What are Auer rods?

no Auer rods present
Auer rods present
don't know

Ringed sideroblasts Ⓦ Ⓕ
• What are ringed sideroblasts?

15% or less
more than 15%
don't know

Chromosomes Ⓘ Ⓦ
• What are chromosomes?
• How are abnormalities identified?

all chromosomes normal

some abnormalities found
Check all that apply:

partial loss of chromosome 5, also known as 5q- or Del(5q)
loss of one of the two 7 chromosomes (monosomy 7)
addition of a third 8 chromosome (trisomy 8)
partial loss of chromosome 20
loss of the Y chromosome
1 other chromosome abnormality not listed above
2 other chromosome abnormalities not listed above
3 or more other chromosome abnormalities not listed above
don't know

Your Classifications

IPSS Score	If you have an IPSS score we'll explain how it was computed. To see your IPSS score, fill in the information marked Ⓘ above. IPSS scores do not apply when your Blasts in bone marrow are more than 30%.
IPSS Classification	Your IPSS classification is determined from your IPSS score.
WHO Subtype	To see your WHO subtype, fill in the information marked Ⓦ above. Your blood and bone marrow findings do not match any of the WHO subtypes.
FAB Subtype	To see your FAB subtype, fill in the information marked Ⓕ above. Your blood and bone marrow findings do not match any of the FAB subtypes.

To reset the form and clear all choices, reload this page or click the Clear Form button above.

Understanding Your MDS Classifications

The classification of MDS into subtypes helps doctors and researches apply statistical groupings to study treatment choices. Knowing your subtype can help you and your doctor determine appropriate treatment. IPSS scores can be used to judge severity and make prognostic estimates.

Different treatment centers rely on different MDS classification schemes. IPSS scores and the WHO system are the most common. The FAB system was used in the past and reflected in medical literature. See MDS Classification for the criteria used for this tool.

Your Classification	IPSS Classification	Information from MD Anderson Cancer Center.
	Low-risk	Least serious MDS. Median survival* about 5 years 8 months.
	Intermediate-1	More serious MDS. Median survival* about 3 years 6 months.
	Intermediate-2	Much more serious MDS. Median survival* about 14 months.
	High-risk	Most serious MDS. Median survival* about 5 months.

Your Classification	WHO Subtype	Information from the National Cancer Institute. See "Survival statistics" explanation below.
	RA (refractory anemia)	About 20% to 30% of all MDS patients. Median survival* about 2 to 5 years. Transformation to AML: rare.
	RARS (refractory anemia with ringed sideroblasts)	About 10% to 12% of MDS patients. Median survival* about 2 to 5 years. Transformation to AML: about 1% to 2%.
	RCMD (refractory cytopenia with multilineage dysplasia)	About 24% of MDS patients. Median survival* about 33 months. Transformation to AML: about 11%. Note: To match this classification the dysplasia in your bone marrow should affect at least 10% of the cells in 2 (or 3) cell types.
	RAEB-1 (refractory anemia with excess blasts-1)	About 40% of MDS patients are RAEB-1 or RAEB-2. Median survival* about 18 months. Transformation to AML: about 25%.
	RAEB-2 (refractory anemia with excess blasts-2)	About 40% of MDS patients are RAEB-1 or RAEB-2. Median survival* about 10 months. Transformation to AML: about 33%.
	MDS Del(5q) (MDS with the 5q- syndrome)	Longer survival. Note: To match this classification the dysplasia in your platelets should exhibit hypolobated nuclei.
	MDS-U (unclassifiable MDS)	MDS that doesn't fall into the other categories.
	AML (acute myeloid leukemia)	not classified as MDS

Your Classification	FAB Subtype	Information from the National Cancer Institute. See "Survival statistics" explanation below.
	RA (refractory anemia)	About 20% to 30% of all MDS patients. Median survival* about 2 to 5 years. Transformation to AML: rare.
	RARS (refractory anemia with ringed sideroblasts)	About 10% to 12% of MDS patients. Median survival* about 2 to 5 years. Transformation to AML: about 1% to 2%.
	RAEB (refractory anemia with excess blasts)	About 40% of MDS patients. Median survival* about 18 months. Transformation to AML: about 25%.
	RAEB-t (refractory anemia with excess blasts in transformation)	About 25% of MDS patients. Median survival* about 6 months. Transformation to AML: about 75%.
	CMML (chronic myelomonocytic leukemia)	not classified as MDS
	AML (acute myeloid leukemia)	not classified as MDS

* Survival statistics: Don't assume that the median survival statistic applies to you. It's a type of average and many patients live beyond, sometimes well beyond, the averages shown. Here's why: (1) "Median survival" means that half of patients survive longer than the time indicated. (2) These statistics reflect treatment from past years, not the latest treatments and techniques for patient care, and survival rates improve over time. (3) The averages apply to all ages; patients under age 60 have even higher averages. (4) Statistics apply to groups of patients but do not indicate your prognosis; every patient is different and individual patients routinely do better than expected.

What happens next?

The method used to determine your subtype is displayed under your MDS Classification. We recommend that you confirm your subtype with your doctor and ask your doctor what it means for your health and treatment.

Privacy Notice

The MDS Classification Tool does not store, save, or upload your data to Marrowforums. The form is cleared of all data each time you load the page or click the Clear Form button.

The data you fill in stays on your own computer and is used only to help you understand your own MDS subtype. We encourage you to protect the privacy of your medical information.

Feedback

Marrowforums would like to hear your feedback on its MDS Classification Tool, to make it as informative and useful as possible. To share your thoughts you can post comments in the Site Comments forum section or contact us privately.