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Updated: Feb 8, 2026

Author Spotlight: Analyzing Bone Marrow Microenvironment in Murine Hematological Malignancies
Published on: November 10, 2023
Can bone marrow cellularity help in predicting prognosis in myelodysplastic syndromes?
Uri Greenbaum1,2, Erel Joffe3,4, Kalman Filanovsky5,6
1Soroka Medical Center, Beer Sheba, Israel.
Bone marrow cellularity does not significantly alter myelodysplastic syndromes (MDS) prognostication. However, hypercellularity in MDS patients with higher blast percentages may indicate a worse prognosis than initially predicted.
Area of Science:
- Hematology
- Oncology
- Clinical Pathology
Background:
- Myelodysplastic syndromes (MDS) prognostication relies on blast percentage (blast%).
- Bone marrow cellularity (BMC) is a key factor in bone marrow assessment.
- The prognostic impact of BMC on blast% interpretation in MDS requires clarification.
Purpose of the Study:
- To evaluate the relevance of bone marrow cellularity (BMC) to the interpretation of blast percentage (blast%) in MDS prognostication.
- To determine if adjusting blast% for BMC improves survival prediction in MDS.
Main Methods:
- Compared survival predictions using blast% adjusted for BMC versus the original IPSS-R blast% grouping.
- Analyzed data from 355 consecutive MDS patients.
Main Results:
- BMC alone or its interaction with blast% was not significantly associated with overall survival (OS).
- A subset of 15% of patients with hypercellular marrow showed a worse prognosis at lower blast% levels.
- Adjusting blast% for BMC did not significantly improve the prognostic power of the IPSS-R (C index 0.71 vs. 0.70).
Conclusions:
- Adjusting blast% for BMC did not enhance MDS prognostication.
- Hypercellularity in MDS patients with higher blast% may signify a worse prognosis than anticipated within existing risk groups.
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