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MDS Mimics Including CHIP, ICUS, and CCUS

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Diagnosis and Management of Myelodysplastic Syndromes

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Abstract

Myelodysplastic syndromes (MDS) are often challenging to diagnose accurately. Diagnostic criteria for MDS include subjective morphologic interpretations or findings of low specificity. There exist several MDS “mimics” that share findings with MDS but are caused by more benign conditions, other neoplasms, or less well-characterized pre-malignant states. Vitamin and iron deficiencies need to be excluded along with autoimmune conditions, medication effects, toxic exposures, viral infections, and congenital syndromes. We now recognize mutational events common to patients with MDS. However, most somatic events indicative of clonal hematopoiesis are not synonymous with MDS as they are found in other myeloid disorders and clonal cytopenias that fail to meet diagnostic criteria for MDS. Interpretation of molecular findings depends on the clinical context in which they occur as the same somatic mutations can have different clinical implications in different settings. This chapter will highlight common MDS mimics with special attention to potentially pre-malignant states.

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Conflict of Interest

Dr. Bejar has received research funding from Celgene and Takeda and served as an advisor to Celgene, Genoptix (NeoGenomics), AbbVie, Daiichi-Sankyo, Forty Seven, and Astex. He is employed by Aptose Biosciences.

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  1. Moores Cancer Center, University of California San Diego, La Jolla, CA, USA

    Rafael Bejar

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  1. Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH, USA

    Aziz Nazha

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Bejar, R. (2020). MDS Mimics Including CHIP, ICUS, and CCUS. In: Nazha, A. (eds) Diagnosis and Management of Myelodysplastic Syndromes. Springer, Cham. https://doi.org/10.1007/978-3-030-51878-3_6

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