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Hematology II > Myelodysplastic Syndromes > Flashcards

Myelodysplastic Syndromes Flashcards

1
Q

What are myelodysplastic syndromes? (MDS)

A

Diverse group of diseases ranging from mild anemia to those that evolve into acute leukemia

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2
Q

MDS diagnostic morphological criteria

A
  • Hard to diagnose by just peripheral blood
  • Ineffective hematopoiesis increases apoptosis
    One or more of following
  • Persistent/progressive cytopenia
  • Dyserythropoiesis
  • Dysmyelopoiesis
  • Dysmegakaryopoiesis
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2
Q

Previous terms for myelodysplastic syndromes?

A
  • Pre-leukemias
  • Refractory anemias (didn’t respond to normal anemia treatment)
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3
Q

Demographics + risk factors

A
  • 70 years median age
  • Environmental and occupational products (ammonia, petrochemicals, benzene, low dose radiation)
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4
Q

MDS diagnostic morphological criteria for dyserythropoiesis

A

Wide variation…
- Oval macrocytes key
- Aniso and poik
- Dimorphic RBC population
- Sideroblasts- possibly ringed
- Pappenheimers
- Multinuclear
- HJ bodies
- Asynchronism
- Basophilic stippling
- Teardrops
- Schistocytes
- Acanthocytes

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5
Q

MDS diagnostic morphological criteria for dysmyelopoiesis

A
  • Neutropenia in 60% of cases
  • Hypogranulation- some agranular
  • Occ hypergranular w/ large granules
  • Usually hyposegmented PMNs with abnormal chromatin (pseudo PH)
  • Asynchronous (basophilic zones = pseudo Dohle)
  • Mixed eos and baso granules
  • Hybrid myelomonocytes
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6
Q

MDS diagnostic criteria for dysmegakaryopoiesis

A
  • Thrombocytopenia in 60% of cases
  • Micromegakaryocytes
  • Abnormal segmentation (hypo/hyper)
  • Hypo or agranular
  • Giant plateletes
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7
Q

MDS lab findings in blood for single lineage dysplasia (MDS-SLD)

A
  • Unicytopenia (usually RBC)
  • Blasts < 1%
  • No Auer rods
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8
Q

Lab findings in bone marrow for MDS-SLD

A
  • Unilineage dysplasia (usually RBC)
  • Blasts < 1%
  • No Auer rods
  • Ringed sideroblasts <15% (usually occ)
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9
Q

Difference between MDS-SLD and MDS-MLD?

A

MDS-MLD has dysplasia in two or more myeloid lineages (neutrophil and/or erythroid precursors and/or megakaryocytes

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10
Q

Lab findings in blood for MDS-RS

A
  • Cytopenias (single, bi or pan)
  • Blasts <1%
  • No Auer rods
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11
Q

Lab findings in bone marrow for MDS-RS

A
  • Single dysplasia OR multi dysplasia in 2+ myeloid lines
  • Blasts <5%
  • No Auer rods
  • Ringed sideroblasts > 15%
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12
Q

Lab findings in blood for MDS with excess blasts-1 (MDS-EB-1)

A
  • Cytopenias
  • Blasts < 5%
  • No Auer rods
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13
Q

Lab findings in bone marrow for MDS-EB-1

A
  • Uni or multi lineage dysplasia
  • 5-9% blasts
  • No Auer rods
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14
Q

Lab findings in blood for MDS-EB-2

A
  • Cytopenias
  • 5-19% blasts with OR without Auer rods
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15
Q

Lab findings in bone marrow for MDS-EB-2

A
  • Uni or multilineage dysplasia
  • 10-19% blasts with OR without Auer rods
16
Q

Lab findings for MDS-EB2 multilineage erythroid/myeloid (doesn’t say if in blood or BM)

A
  • Dysplasia
  • 50% RBC precursors
  • Myeloblasts < 20% and left shift
  • May see Auer rods
17
Q

Lab findings in blood for MDS associated with isolated del (5q)

A
  • Cytopenia(s)
  • Blasts < 1%
18
Q

Lab findings in bone marrow for MDS associated with isolated del (5q)

A
  • Single or multi lineage dysplasia
  • Blasts < 5%
  • No Auer rods
  • Isolated del (5q)
19
Q

Lab findings for chronic myelomonocytic leukemia (CMML)

A
  • Increased WBC
  • Higher monos, promonos, mature and immature granulocytes
  • Blasts < 20%
  • CMML-1: PB Blasts < 5%, BM Blasts <10%
  • CMML-2: PB blasts 5-15%, BM blasts 10-19%
20
Q

List other MDS/MPN combo diseases

A
  • Atypical chronic myeloid leukemia (aCML)
  • Juvenile myelomonocytic leukemia (JMML)
    - MDS/MPN with ringed sideroblasts + thrombocytosis
  • MDS/MPN, unclassified
21
Q

Causes of secondary or therapy-related MDS

A
  • Secondary to treatment of other malignancy (chemo or radiation)
  • Toxins, such as benzene

Hematology II (8 decks)

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