Myelodysplastic Syndrome (MDS) Flashcards
What are the three groups of Chronic Myeloproliferative disorders?
- AML
- CMPD
- MDS
State the Etiology of MDS
- progressive cytopenia in p.b. due to cytokines killing normal cells
- involves chromosome 5&7
- most involve defect @ myeloid stem cell
- apoptosis increased early in dz, decreased later when converting
- results: ineffective clonal HSC and morph. dysplasia
-Refractory
-cells have abn fx’n
In MDS ALL have…
dyserythropoiesis- occurs first. Begin to see oval macrocytes. First thought may be megaloblastic anemia leading to B12 & folate studies but resulting normal.
In MDS Most have..
dysmyelopoiesis- persistant basophilic cytoplasm
In MDS SOME have
dysmegakaryopoiesis- bizarre and mononuclear megK
-nuclear bridging also seen
What is Refractory?
resistant to therapy; tx’t
What are clinical symptoms of MDS in p.B.?
-progressive cytopenia
- megaloblastoid dyserythropoiesis manifesting in pB as Hgb <10 g/dL, aniso, poik, HJ, Basophilic, BIZARRE nRBC
-neutrophenia
-giant plts
In p.B. MDS, neutropenia presents with…
↑metas, ↑myelos
may have aurods, pseudo-pelger-huet
What are the lab findings In B.M. MDS?
- always hypercellular due to erythroid hyperplasia
- ringed sideroblasts
Megaloblastoid dyserythropoiesis
RC
-5q syndrome seen in elderly women- indicates stable deletion syndrome leading to good prognosis
- condition called refractory pancytopenia
-oval macrocytes
-<15% ringed sideroblasts
-normal B12 &folate
RARS
- > 15% ringed sideroblasts
+RA
+dimorphic population
RAEB
+RA
+cytopenia >2 cell lines
+B.M. blasts 5-20%
Chronic myelomonocytic Leukemia (CMML)
+RA
+ ↑monos>20%
** no AMML; still myelodysplastic
What stain would you use for monos ?
NSE 4+
followed with NaFl
