Table 3.

Classification of UA, ICUS-A, and pre-MDS conditions

ConditionUAICUS-ACCUSIDUSCHIPMDS
Low riskHigh risk
Cytopenia* − − 
Dysplasia nd − − − 
BM blasts, % nd <5% <5% <5% <5% <5% >20% 
Cytogenetic abnormalities nd −/+ − −/+ +/− ++ 
Molecular aberrations nd − − +++ 
Comment Workup needed Cytopenic patients Noncytopenic patients Classification of MDS is based on WHO definition 
ConditionUAICUS-ACCUSIDUSCHIPMDS
Low riskHigh risk
Cytopenia* − − 
Dysplasia nd − − − 
BM blasts, % nd <5% <5% <5% <5% <5% >20% 
Cytogenetic abnormalities nd −/+ − −/+ +/− ++ 
Molecular aberrations nd − − +++ 
Comment Workup needed Cytopenic patients Noncytopenic patients Classification of MDS is based on WHO definition 

“Unexplained anemia” (UA) is the term used in the literature so far. In these patients, a thorough workup including BM and molecular analyses is recommended. These investigations will enable classification of the diagnosis ICUS-A, CCUS, or MDS or will help exclude other malignant hematologic disorders. Based on Valent et al.

IDUS, idiopathic dysplasia of undetermined significance; nd, not detected or not done.

*

The definition of anemia in cytopenia is based on WHO criteria: Hb <130 g/L in men and Hb <120 g/L in women.10 

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