<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2301-1254</journal-id>
<journal-title><![CDATA[Anales de la Facultad de Medicina]]></journal-title>
<abbrev-journal-title><![CDATA[Anfamed]]></abbrev-journal-title>
<issn>2301-1254</issn>
<publisher>
<publisher-name><![CDATA[Universidad de la República. Facultad de Medicina]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2301-12542023000101201</article-id>
<article-id pub-id-type="doi">10.25184/anfamed2023v10n1a4</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Herramientas diagnostico-terapéuticas en síndromes mielodisplásicos en Uruguay.]]></article-title>
<article-title xml:lang="en"><![CDATA[Diagnostic and therapeutic tools in myelodysplastic syndromes in Uruguay]]></article-title>
<article-title xml:lang="pt"><![CDATA[Instrumentos diagnóstico-terapêuticos nas síndromes mielodisplásicas no Uruguai]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Boada]]></surname>
<given-names><![CDATA[Matilde]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Belli]]></surname>
<given-names><![CDATA[Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Crisp]]></surname>
<given-names><![CDATA[Renee]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Iastrebner]]></surname>
<given-names><![CDATA[Marcelo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guillermo]]></surname>
<given-names><![CDATA[Cecilia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Grille]]></surname>
<given-names><![CDATA[Sofia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Facultad de Medicina Cátedra de Hematología. Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Academia Nacional de Medicina Instituto de Medicina Experimental (IMEX-CONICET) Laboratorio de Genética Hematológica,]]></institution>
<addr-line><![CDATA[Ciudad de Buenos Aires ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Nacional Prof. Alejandro Posadas, Haedo, Servicio de Hematología ]]></institution>
<addr-line><![CDATA[Buenos Aires ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Sanatorio Sagrado Corazón, Servicio de Hematología ]]></institution>
<addr-line><![CDATA[Buenos Aires ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad de la República Facultad de Medicina Laboratorio de Citometría y Biología Molecular. Depto. Básico de Medicina. Hospital de Clínicas]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>10</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S2301-12542023000101201&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S2301-12542023000101201&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S2301-12542023000101201&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Los Síndromes Mielodisplásicos (SMD) son un grupo heterogéneo de enfermedades mieloides. Esta heterogeneidad en la presentación clínica complejiza el diagnóstico requiriendo diversos estudios complementarios. El tratamiento debe ser individualizado y adaptado al riesgo, desde terapias de soporte hasta intervenciones de alto costo. Para conocer la accesibilidad a las herramientas diagnóstico y terapéuticas se realizó una encuesta online dirigida a los hematólogos que asisten pacientes con SMD en Uruguay en 2016 y 2019. Las encuestas fueron respondidas por 32.5% y 26.6% de los miembros de la Sociedad de Hematología del Uruguay. Más del 90% tienen acceso a estudios histológicos, citogenéticos, FISH y citometría de flujo. La posibilidad de realizar paneles de secuenciación masiva se encuentra restringida a menos de 10% derivando la muestra al exterior, siendo mayor en 2019 en comparación a 2016. Los sistemas de estratificación de riesgo más utilizados son el sistema internacional de puntuación de riesgo (IPSS) y su versión revisada (IPSS-R). La disponibilidad de tratamientos de soporte (transfusiones, eritropoyetina y G-CSF), de azacitidina y del trasplante alogénico de precursores hematopoyéticos es amplia. Existió un aumento en indicación de azacitidina en 2019 con respecto a 2016. Sin embargo, el acceso a decitabina, lenalidomida y fármacos quelantes de hierro es escaso y no se cuenta con ensayos clínicos donde incluir pacientes que fallan o no responden a los tratamientos convencionales. La presente encuesta, realizada en dos períodos, describe la realidad y su evolución en nuestro país en cuanto a accesibilidad a herramientas diagnósticas y terapéuticas extrapolables a otras patologías oncohematológicas. Los datos recabados permitirán plantear estrategias tendientes a mejorar el abordaje diagnóstico-terapéutico de los pacientes con SMD en Uruguay.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Myelodysplastic Syndromes (MDS) constitutes an heterogenous group of hematological malignancies. Reaching an accurate diagnosis, represents in an important number of cases, a major challenge that requires different diagnostic tools. In order to acknowledge the scope of access to those tools in our country, we performed a survey addressed to Uruguayan hematologists who care for MDS patients in their clinical practice. The survey was carried out in 2016 and 2019 among Uruguayan Hematology Society members. Response rate was 32.5% and 26.6% respectively. Access to bone marrow biopsy, cytogenetics, FISH and flow cytometry was accessible to more than 90% of physicians. Less than 10% of respondents were able to request next generation sequencing (NGS) studies and in that case, they have to send them abroad. IPSS and R-IPSS were the most frequently used risk scores. Support treatment such as growth factors and transfusions are widely accessible. Azacytidine and allogenic transplant are available as well. However, access to decitabine, lenalidomide and iron chelating drugs is scarce and there are no clinical trials to include patients who fail or do not respond to conventional treatments. This survey, carried out in two periods, describes the reality and its evolution in our country in terms of accessibility to diagnostic and therapeutic tools that can be extrapolated to other oncohematological pathologies. We were able to get to know our country reality regarding diagnostic and therapeutic tools for MDS patients. This, would represent an important input in order to design health strategies aiming to improve clinical care for our patients.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: As Síndromes Mielodisplásicas (SMD) são um grupo heterogêneo de doenças mielóides. Essa heterogeneidade na apresentação clínica torna o diagnóstico mais complexo, exigindo vários estudos complementares. O tratamento deve ser individualizado e adaptado ao risco, desde terapias de suporte até intervenções de alto custo. Para conhecer a acessibilidade de ferramentas diagnósticas e terapêuticas, foi realizada uma pesquisa online dirigida aos hematologistas que atendem pacientes com SMD no Uruguai em 2016 e 2019. As pesquisas foram respondidas por 32,5% e 26,6% dos membros da Sociedad de Hematologia do Uruguai. Mais de 90% têm acesso a estudos histológicos, citogenéticos, FISH e citometria de fluxo. A possibilidade de realização de painéis de sequenciamento massivo está restrita a menos de 10% provenientes da amostra no exterior, sendo maior em 2019 em relação a 2016. Os sistemas de estratificação de risco mais utilizados são o sistema internacional de pontuação de risco (IPSS) e sua versão revisada (IPSS -R). Tratamentos de suporte (transfusões, eritropoietina e G-CSF), azacitidina e transplante alogênico de células-tronco hematopoiéticas estão amplamente disponíveis. Houve aumento da indicação de azacitidina em 2019 em relação a 2016. No entanto, o acesso a decitabina, lenalidomida e quelantes de ferro é escasso e não há ensaios clínicos para incluir pacientes que falham ou não respondem aos tratamentos convencionais. Este inquérito, realizado em dois períodos, descreve a realidade e a sua evolução no nosso país em termos de acessibilidade a instrumentos diagnósticos e terapêuticos que podem ser extrapolados para outras patologias onco-hematológicas. Os dados coletados permitirão propor estratégias destinadas a melhorar a abordagem diagnóstico-terapêutica de pacientes com SMD no Uruguai.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Síndromes Mielodisplásicos]]></kwd>
<kwd lng="es"><![CDATA[encuesta]]></kwd>
<kwd lng="es"><![CDATA[diagnóstico]]></kwd>
<kwd lng="es"><![CDATA[tratamiento]]></kwd>
<kwd lng="en"><![CDATA[Myelodysplastic Syndrome]]></kwd>
<kwd lng="en"><![CDATA[survey]]></kwd>
<kwd lng="en"><![CDATA[diagnosis]]></kwd>
<kwd lng="en"><![CDATA[treatment]]></kwd>
<kwd lng="pt"><![CDATA[Síndromes mielodisplásicas]]></kwd>
<kwd lng="pt"><![CDATA[pesquisa]]></kwd>
<kwd lng="pt"><![CDATA[diagnóstico]]></kwd>
<kwd lng="pt"><![CDATA[tratamento]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Swerdlow]]></surname>
<given-names><![CDATA[SH]]></given-names>
</name>
<name>
<surname><![CDATA[Campo]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Harris]]></surname>
<given-names><![CDATA[NL]]></given-names>
</name>
</person-group>
<source><![CDATA[WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues]]></source>
<year>2008</year>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kane E]]></surname>
<given-names><![CDATA[V.]]></given-names>
</name>
<name>
<surname><![CDATA[Calderwood]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Dobbie]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A population-based study of venous thrombosis in pregnancy in Scotland 1980-2005.]]></article-title>
<source><![CDATA[European Journal of Obstetrics &amp; Gynecology and Reproductive Biology]]></source>
<year>2013</year>
<volume>169</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>223-9</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rollison]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
<name>
<surname><![CDATA[Howlader]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Smith]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology of myelodysplastic syndromes and chronic myeloproliferative disorders in the United States, 2001-2004, using data from the NAACCR and SEER programs.]]></article-title>
<source><![CDATA[Blood]]></source>
<year>2008</year>
<volume>112</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>45-52</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4.</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Valent]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Horny]]></surname>
<given-names><![CDATA[HP]]></given-names>
</name>
<name>
<surname><![CDATA[Bennett]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<source><![CDATA[Definitions and standards in the diagnosis and treatment of the myelodysplastic syndromes: Consensus statements and report from a working conference. Leukemia Research]]></source>
<year>2007</year>
</nlm-citation>
</ref>
<ref id="B5">
<label>5.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Greenberg]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Cox]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[LeBeau]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[International scoring system for evaluating prognosis in myelodysplastic syndromes.]]></article-title>
<source><![CDATA[Blood]]></source>
<year>1997</year>
<volume>89</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>2079-88</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Greenberg]]></surname>
<given-names><![CDATA[PL]]></given-names>
</name>
<name>
<surname><![CDATA[Tuechler]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Schanz]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Revised International Prognostic Scoring System for Myelodysplastic Syndromes]]></article-title>
<source><![CDATA[Blood]]></source>
<year>2012</year>
<volume>120</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>2454-65</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Malcovati]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Della]]></surname>
<given-names><![CDATA[Porta MG]]></given-names>
</name>
<name>
<surname><![CDATA[Pascutto]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prognostic Factors and Life Expectancy in Myelodysplastic Syndromes Classified According to WHO Criteria: A Basis for Clinical Decision Making]]></article-title>
<source><![CDATA[Journal of Clinical Oncology]]></source>
<year>2005</year>
<volume>23</volume>
<numero>30</numero>
<issue>30</issue>
<page-range>7594-603</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Komrokji]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Corrales-Yepez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Al Ali]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Validation of the MD Anderson Prognostic Risk Model for patients with myelodysplastic syndrome.]]></article-title>
<source><![CDATA[Cancer]]></source>
<year>2012</year>
<volume>118</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>2659-64</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Spira]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Yurgelun]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Alexandrov]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Cancer Res]]></source>
<year>2017</year>
<volume>77</volume>
<numero>7</numero>
<issue>7</issue>
</nlm-citation>
</ref>
<ref id="B10">
<label>10.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Spaulding]]></surname>
<given-names><![CDATA[TP]]></given-names>
</name>
<name>
<surname><![CDATA[Stockton]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Savona]]></surname>
<given-names><![CDATA[MR.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The evolving role of next generation sequencing in myelodysplastic syndromes]]></article-title>
<source><![CDATA[British Journal of Haematology.]]></source>
<year>2020</year>
<volume>188</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>224-39</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nazha]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bejar]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Molecular Data and the IPSS-R: How Mutational Burden Can Affect Prognostication in MDS]]></article-title>
<source><![CDATA[Curr Hematol Malig Rep]]></source>
<year>2017</year>
<volume>12</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>461-7</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fenaux]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Platzbecker]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Ades]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[How we manage adults with myelodysplastic syndrome.]]></article-title>
<source><![CDATA[British Journal of Haematology]]></source>
<year>2020</year>
<volume>189</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1016-27</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fenaux]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Haase]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Sanz]]></surname>
<given-names><![CDATA[GF]]></given-names>
</name>
<name>
<surname><![CDATA[Santini]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Buske]]></surname>
<given-names><![CDATA[C.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Myelodysplastic syndromes: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up]]></article-title>
<source><![CDATA[Annals of Oncology]]></source>
<year>2014</year>
<volume>25</volume>
<page-range>57-69</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fenaux]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Haase]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Santini]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Myelodysplastic syndromes: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up&#8224;]]></article-title>
<source><![CDATA[Annals of Oncology.]]></source>
<year>2021</year>
<volume>32</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>142-56</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15.</label><nlm-citation citation-type="">
<source><![CDATA[NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Myelodysplastic Syndromes - mds.pdf]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Alfonso]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Arbelbide]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Basquiera]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Síndromes mielodisplásicos y síndromes de superposición mielodisplasia / neoplasia mieloproliferativa. Guías de Diagnóstico y Tratamiento. Sociedad Argentina de Hematología]]></source>
<year>2019</year>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Magalhães]]></surname>
<given-names><![CDATA[SMM]]></given-names>
</name>
<name>
<surname><![CDATA[Niero-Melo]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Chauffaille M de]]></surname>
<given-names><![CDATA[LLF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Guidelines on myelodysplastic syndromes: Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular.]]></article-title>
<source><![CDATA[Hematology, Transfusion and Cell Therapy]]></source>
<year>2018</year>
<volume>40</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>255-61</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Malcovati]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Hellström-Lindberg]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Bowen]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnosis and treatment of primary myelodysplastic syndromes in adults: Recommendations from the European LeukemiaNet.]]></article-title>
<source><![CDATA[Blood]]></source>
<year>2013</year>
<volume>122</volume>
<numero>17</numero>
<issue>17</issue>
<page-range>2943-2964.</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Campbell]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Roland]]></surname>
<given-names><![CDATA[MO]]></given-names>
</name>
<name>
<surname><![CDATA[Buetow]]></surname>
<given-names><![CDATA[SA.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Defining quality of care]]></article-title>
<source><![CDATA[Social Science and Medicine]]></source>
<year>2000</year>
<volume>51</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1611-25</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Crisp]]></surname>
<given-names><![CDATA[renee]]></given-names>
</name>
<name>
<surname><![CDATA[Bestach]]></surname>
<given-names><![CDATA[Yesica]]></given-names>
</name>
<name>
<surname><![CDATA[Kornblihtt]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<name>
<surname><![CDATA[Lazzarino]]></surname>
<given-names><![CDATA[Carolina]]></given-names>
</name>
<name>
<surname><![CDATA[Iastrebner]]></surname>
<given-names><![CDATA[Marcelo]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[Jaqueline]]></given-names>
</name>
<name>
<surname><![CDATA[Arbelbide]]></surname>
<given-names><![CDATA[Jorge]]></given-names>
</name>
<name>
<surname><![CDATA[Carolina]]></surname>
<given-names><![CDATA[Belli]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Preferencias y limitaciones de los hematólogos para afrontar la complejidad de los síndromes mielodisplásicos]]></article-title>
<source><![CDATA[Medicina (B Aires).]]></source>
<year>2019</year>
<volume>79</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>174-784</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Arber]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
<name>
<surname><![CDATA[Orazi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Hasserjian]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia.]]></article-title>
<source><![CDATA[Blood]]></source>
<year>2016</year>
<volume>127</volume>
<numero>20</numero>
<issue>20</issue>
<page-range>2391-405</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Valent]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Orazi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Steensma]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Proposed minimal diagnostic criteria for myelodysplastic syndromes (MDS) and potential pre-MDS conditions]]></article-title>
<source><![CDATA[Oncotarget]]></source>
<year>2017</year>
<volume>8</volume>
<numero>43</numero>
<issue>43</issue>
<page-range>73483-500</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Crisp]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Flores]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Enrico]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Accesibilidad de herramientas diagnóstico-terapéuticas para los pacientes con síndromes mielodisplásicos en la República Argentina]]></article-title>
<source><![CDATA[Revista Hematología]]></source>
<year>2017</year>
<volume>21</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>127-38</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[D]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[GJ]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Standardizing the initial evaluation for myelodysplastic syndromes]]></article-title>
<source><![CDATA[Current hematologic malignancy reports]]></source>
<year>2013</year>
<volume>8</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>361-9</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Garcia-Manero]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Chien]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
<name>
<surname><![CDATA[Montalban-Bravo]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Myelodysplastic syndromes: 2021 update on diagnosis, risk stratification and management.]]></article-title>
<source><![CDATA[American Journal of Hematology.]]></source>
<year>2020</year>
<volume>95</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1399-420</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26.</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Greenberg]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Cox]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Lebeau]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
</person-group>
<source><![CDATA[International Scoring System for Evaluating Prognosis in Myelodysplastic Syndromes from patients with primary MDS from seven previously re.]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Greenberg]]></surname>
<given-names><![CDATA[PL]]></given-names>
</name>
<name>
<surname><![CDATA[Tuechler]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Schanz]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Revised international prognostic scoring system for myelodysplastic syndromes.]]></article-title>
<source><![CDATA[Blood]]></source>
<year>2012</year>
<volume>120</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>2454-2465.</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cazzola]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Myelodysplastic Syndromes]]></article-title>
<source><![CDATA[New England Journal of Medicine]]></source>
<year>2020</year>
<volume>383</volume>
<numero>14</numero>
<issue>14</issue>
<page-range>1358-1374.</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[PT]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[NA]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factors affecting response to 5-azacytidine and prognosis of myelodysplastic syndrome. Is long-term survival a realistic goal?]]></article-title>
<source><![CDATA[Leukemia research.]]></source>
<year>2021</year>
<page-range>103</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Haferlach]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Nagata]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Grossmann]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Landscape of genetic lesions in 944 patients with myelodysplastic syndromes]]></article-title>
<source><![CDATA[Leukemia]]></source>
<year>2014</year>
<volume>28</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>241-7</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tefferi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gangat]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Mudireddy]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mayo Alliance Prognostic Model for Myelodysplastic Syndromes: Integration of Genetic and Clinical Information]]></article-title>
<source><![CDATA[Mayo Clinic Proceedings]]></source>
<year>2018</year>
<volume>93</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1363-1374.</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bejar]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[Prognostic models in myelodysplastic syndromes]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B33">
<label>33.</label><nlm-citation citation-type="confpro">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Crisp]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Vidal-Senmache]]></surname>
<given-names><![CDATA[Gabriela]]></given-names>
</name>
<name>
<surname><![CDATA[Navarro Cabrera]]></surname>
<given-names><![CDATA[Juan]]></given-names>
</name>
<name>
<surname><![CDATA[Huaman-Garaicoa]]></surname>
<given-names><![CDATA[Fuad]]></given-names>
</name>
<name>
<surname><![CDATA[Maldonado]]></surname>
<given-names><![CDATA[Bella]]></given-names>
</name>
<name>
<surname><![CDATA[Undurraga Sutton]]></surname>
<given-names><![CDATA[Maria Soledad]]></given-names>
</name>
<name>
<surname><![CDATA[Valladares]]></surname>
<given-names><![CDATA[Ximena]]></given-names>
</name>
<name>
<surname><![CDATA[Reyes]]></surname>
<given-names><![CDATA[Virginia]]></given-names>
</name>
<name>
<surname><![CDATA[Pimentel]]></surname>
<given-names><![CDATA[Mayra]]></given-names>
</name>
<name>
<surname><![CDATA[Ayala]]></surname>
<given-names><![CDATA[Apolina]]></given-names>
</name>
<name>
<surname><![CDATA[Grille]]></surname>
<given-names><![CDATA[Sofia]]></given-names>
</name>
<name>
<surname><![CDATA[Guillermo]]></surname>
<given-names><![CDATA[Cecilia]]></given-names>
</name>
</person-group>
<source><![CDATA[Access to diagnostic and therapeutic tools for Myelodysplastic Syndromes in general practice: survey among Latin-American hematologists]]></source>
<year>2018</year>
<conf-name><![CDATA[ 23rdEuropean Hematology Association (EHA) Congress.]]></conf-name>
<conf-loc> </conf-loc>
</nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Crisp]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Vidal-Senmache]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Navarro Cabrera]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Access to Diagnostic and Therapeutic Tools for Myelodysplastic Syndromes in General Practice: Survey Among South-American Hematologists]]></article-title>
<source><![CDATA[Leukemia Research.]]></source>
<year>2017</year>
<volume>55</volume>
<page-range>S85-6</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Say]]></surname>
<given-names><![CDATA[RE]]></given-names>
</name>
<name>
<surname><![CDATA[Thomson]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The importance of patient preferences in treatment decisions-challenges for doctors]]></article-title>
<source><![CDATA[The BMJ.]]></source>
<year>2003</year>
<volume>327</volume>
<numero>7414</numero>
<issue>7414</issue>
<page-range>542</page-range></nlm-citation>
</ref>
<ref id="B36">
<label>36</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[AM]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[EA]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[To chelate or not to chelate in MDS: That is the question!]]></article-title>
<source><![CDATA[Blood reviews]]></source>
<year>2018</year>
<volume>32</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>368-377.</page-range></nlm-citation>
</ref>
<ref id="B37">
<label>37.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[L]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[MG]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[C]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prognostic factors and life expectancy in myelodysplastic syndromes classified according to WHO criteria: a basis for clinical decision making. Journal of clinical oncology : official]]></article-title>
<source><![CDATA[Journal of the American Society of Clinical Oncology]]></source>
<year>2005</year>
<volume>23</volume>
<numero>30</numero>
<issue>30</issue>
<page-range>7594-7603.</page-range></nlm-citation>
</ref>
<ref id="B38">
<label>38</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vinchi]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Hell]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Platzbecker]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Controversies on the Consequences of Iron Overload and Chelation in MDS]]></article-title>
<source><![CDATA[Hema Sphere]]></source>
<year>2020</year>
<volume>4</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B39">
<label>39</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[N]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Do Recent Randomized Trial Results Influence which Patients with Myelodysplastic Syndromes Receive Iron Chelation?]]></article-title>
<source><![CDATA[Hematology/oncology clinics of North America.]]></source>
<year>2020</year>
<volume>34</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>465-73</page-range></nlm-citation>
</ref>
<ref id="B40">
<label>40</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Angelucci]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Greenberg]]></surname>
<given-names><![CDATA[PL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Safety and Efficacy, Including Event-Free Survival, of Deferasirox Versus Placebo in Iron-Overloaded Patients with Low- and Int-1-Risk Myelodysplastic Syndromes (MDS): Outcomes from the Randomized, Double-Blind Telesto Study.]]></article-title>
<source><![CDATA[Blood]]></source>
<year>2018</year>
<volume>132</volume>
<numero>Supplement 1</numero>
<issue>Supplement 1</issue>
<page-range>234</page-range></nlm-citation>
</ref>
<ref id="B41">
<label>41</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Haase]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Germing]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Schanz]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[New insights into the prognostic impact of the karyotype in MDS and correlation with subtypes: evidence from a core dataset of 2124 patients.]]></article-title>
<source><![CDATA[Blood]]></source>
<year>2007</year>
<volume>110</volume>
<numero>13</numero>
<issue>13</issue>
<page-range>4385-95</page-range></nlm-citation>
</ref>
<ref id="B42">
<label>42</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[A]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[G]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[J]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lenalidomide in the myelodysplastic syndrome with chromosome 5q deletion.]]></article-title>
<source><![CDATA[The New England journal of medicine.]]></source>
<year>2006</year>
<volume>355</volume>
<numero>14</numero>
<issue>14</issue>
<page-range>1456-65</page-range></nlm-citation>
</ref>
<ref id="B43">
<label>43</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[A]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[S]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[DJ]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Efficacy of lenalidomide in myelodysplastic syndromes.]]></article-title>
<source><![CDATA[The New England journal of medicine.]]></source>
<year>2005</year>
<volume>352</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>549-57</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
