Myelodysplastic Syndromes with Bone Marrow Fibrosis: An Update

Ann Lab Med. 2022 May 1;42(3):299-305. doi: 10.3343/alm.2022.42.3.299.


Myelodysplastic syndrome (MDS) is a diverse hematological malignancy with a wide spectrum of presentations and implications. Treatment strategies for patients with MDS heavily rely on prognostic scoring systems, such as the revised international prognostic scoring system (IPSS-R). Bone marrow fibrosis (BMF) has been identified as an independent risk factor for poor survival in patients with MDS, irrespective of the IPSS-R risk category. However, BMF is not widely included in scoring systems and is not always considered by clinicians when making treatment decisions for patients. In this review, we discuss the available literature about the presentation and prognosis of patients with MDS and concurrent BMF. The prognostic impact of BMF should be factored in when deciding on transplant candidacy, especially for intermediate-risk patients.

Keywords: Allogeneic stem cell transplantation; Bone marrow fibrosis; International prognostic scoring system; Myelodysplastic syndrome.

Publication types

  • Review

MeSH terms

  • Humans
  • Myelodysplastic Syndromes* / complications
  • Myelodysplastic Syndromes* / diagnosis
  • Myelodysplastic Syndromes* / therapy
  • Primary Myelofibrosis* / diagnosis
  • Prognosis
  • Risk Factors