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Myelodysplasia

 

 

 

Diagnosis

 

Minimal Diagnostic Criteria for MDS:

1. Sustained unexplained cytopenia:

  • Neutropenia <1.8
  • Thrombocytopenia <100
  • Anemia <100

 

2. Morphological myelodysplasia:

  • >10% of the cell line

 

3. Acquired clonal cytogenetic abnormality in hematopoietic cells or persistent cytopenia >6 months

 

 

Clinical and Blood work

  • MDS often presents with pancytopenia
  • Single lineage cytopenia less common
  • Organomegaly very rare
  • Macrocytosis is common (elevated MCV)
  • Fetal Hb is often slightly elevated
  • Leukocyte count low to normal - absolute or functional cytopenia

 

Bone Marrow

  • Hypercellular or normocellular bone marrow
  • Dysplastic features:
    • Megaloblastic erythropoiesis
    • Bizarre small or unusual large megakaryocytes
    • Dysgranulopoiesis
  • Percent of myeloblasts may be increased but is less than 20%

 

Differential Diagnosis

Disorders which may present with similar morphological features include:

  • Viral infections (eg. CMV, HHV, parvovirus)
  • Vitamin deficiencies (B12, folate, E)
  • PNH
  • Other disorders:
    • Rheumatological
    • Metabolic
    • Autoimmune

 

 

 

 

 

 

 

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