Copper Concentrations Should Be Measured Under Any Circumstances
The citation from the European Leukemia Net that the authors used in their article (1) has an online appendix 1 in the 24 October issue of Blood, which in 26 points raises the clinical key questions of the myelodysplastic syndrome (MDS). This is very helpful in the context of this disorder.
Table 1 in the article by Germing et al. shows the differential diagnoses to MDS and, among others, mentions copper deficiency. When considering the median age of patients with MDS and bariatric surgery—which has increased in the meantime—then in the diagnostic evaluation of MDS copper concentrations should be measured, at least for the group at low risk (2). The cytogenetic risk groups are subject to certain driver mutations of MDS, which are implemented as significant prognostic variables (3). For low-risk MDS, idiopathic cytopenia of undetermined significance (ICUS) and idiopathic dysplasia of uncertain significance (IDUS) represent an additional challenge.
Dr. med. Antonis G. Tsamaloukas
|1.||Germing U, Kobbe G, Haas R, Gattermann N: Myelodysplastic syndromes: diagnosis, prognosis and treatment. Dtsch Arztebl Int 2013; 110(46): 783–90 VOLLTEXT|
|2.||Gabreyes AA, Abbasi HN, Forbes KP, et al.: Hypocupremia associated cytopenia and myelopathy: a national retrospective review. Eur J Haematol 2013; 90: 1–9 CrossRef MEDLINE|
|3.||Papaemmanuil E, Cazzola M, Boultwood J, et al.: Clinical and biological implications of driver mutations in myelodysplastic syndromes. Blood 2013; 122: 3616–27 CrossRef MEDLINE PubMed Central|
|4.||Valent P, Bain BJ, Bennett JM, et al.: Idiopathic cytopenia of undetermined significance (ICUS) and idiopathic dysplasia of uncertain significance (IDUS), and their distinction from low risk MDS. Leukemia research 2012; 36: 1–5 MEDLINE|