[akita]

Dan,

"Margarete, the diagnosis that I have been given falls under the newer WPSS classifications as either RT or RCMD, which have varying prognoses. The predominant issue seems to be the refractory thrombocytopenia".

Do you mean that your thrombocytopenia is more important for your prognosis as the mild displasias in your red and white cell bone marrow?

"How would we determine if risk of progression is relatively low?"

The doctors should estimate this.

Generally the prognosis scores give a guideline to estimating, plus many extra parameters that should be assessed individually.Therefore i find that it could help trying to determine the prognosis on the basis of your FAB or WH0 classifcation, and then go further and look where your extras are. In your case this extras seem to start in the fact that, given your informations, you seem to be neither RT nor RMCD, see the WHO criteria. You could try now to check: Whats the difference between the RT resp. RMCD - Scoring and my special blood report? RT has only one dysplasia, but this dysplasia must be in the cell line where you also have the cytopenia. But you have got two dysplasias, and in the other cell lines. RMCD is only given, if you have 2 cytopenias. But you have got only one. i hope that here did not accur an error to me.. So you cannot rely on the prognoses for one of these, RT or RMCD. If you consider´beeing "in between", this could perhaps also not help much, because other parameters could lead to a poor prognosis to you in spite of the lower risk category/ies in which you seem to fall actually.= low or int-1 = "lower risk". See the article in the MDS subforum,which i posted recently and where a lot of relevant parameters for a poor prognosis are indicated. You should try to check that. Doing that with your doctor you can get more safety for prognosis I have also now copied the fulltext article in our library and would be happy to answer extra questions which have remained unclear after reading the abstract or just send you the copy by post or telefax, if you like. Further you really seem to be one of quite a lot of persons whose diagnosis lies not far away from ITP. There exist several reports concerning the differantialdiagnosis between ITP and MDs with thrombocytopenia. Maybe studying of these studies/report can bring new insights for your situation.


You could try to check these questions as a preparation for a second-opinion talk with a MDs -´specialist.

Good night!

Margarete