UNIT 4: MDS Flashcards
Group of morphological abnormalities
○ Elderly patients
Heterogenous and affected all cell lines
○ Remain stable for years
○ Progress rapidly to death
Refractory anemia, smoldering leukemia, oligoblastic leukemia, or
preleukemia
MDS
Acquired clonal disorders
Progressive cytopenias in PB
○ Defects on all cell lines
○Transform to AML
MDS
Progressive cytopenias despite cellular BM
Dyspoiesis in one or more cell lines
Disruption of apoptosis
○ Ineffective hematopoiesis
Transformation to leukemia is apparent
○Apoptosis is decreased
MDS
Dyserythropoiesis
Poikilocytosis
Basophilic stippling
Howell-Jolly bodies
Siderocytes
MDS
Defective development of RBCs
Observance of dimorphic RBC population
Oval macrocytes, hypochromic microcytes
dyserythropoiesis
also observed in cases of vitamin B12
or folic acid deficiency anemia
oval macrocytes
determine levels of stored iron,
or the adequacy of stored iron.
hypochromic microcytes
Multinucleated
RBC precursor or
abnormal nuclear
shape
Basophilic
stippling
Ringed
sideroblasts
dyserythropoiesis
Dimorphic RBC
population
Oval macrocytes
(most common)
Hypochromic
microcytic
dyserythropoiesis
N/C asynchrony
Uneven
cytoplasmic
staining
Abnormal
granulation
Abnormal
nuclear
segmentation
Hyperplasia or
hypoplasia
dysmyelopoiesis
Basophilia
(indicating
nuclear-cytoplasm
ic asynchrony)
Large granules,
hypogranulation,
or absence of
granules
Hyposegmentation,
hypersegmentatio n, or nuclear rings
dysmyelopoiesis
Darkly stained in
both BM and
PBS.
dysmyelopoiesis
Large
mononuclear
megakaryocytes
Micromegakaryo cytes or
micromegakaryo blasts
Bilobed or
multiple small
separated nuclei
dysmegakaryopoiesis
Dyspoietic
morphology
Giant platelets
Abnormal granulation
hypogranular or agranular
Micromegakaryocytes
maybe present
dysmegakaryopoiesis
Dysplasia
○ At least one cell line
Cytogenetic abnormalities
○ 50% of cases
○ None is specific to
diagnosis
MDS-SLD
Cytopenias in one or more cell
lines
Dysplasia in two or more cell
lines
MDS-MLD
Formerly known as refractory
cytopenia with multilineage
dysplasia
MDS MLD
Mutation in SF3B1
○ 5% of ringed nucleated
erythroid cells
MDS-RS
No mutation detected
○15% of ringed nucleated
erythroid cells
Dimorphic PB
○Hypochromic and
normochromic cells
MDS RS
Trilineage cytopenias
MDS EB
Auer rods
■ The presence of Auer
rods, regardless of
blast count, qualifies a
case as
MDS EB2
Affects women predominantly
Anemias without other
cytopenias
No Auer rods
MDS ISOLATED DEL (5q)
Initially lack specific changes
necessary for classification into
other MDS subtypes
Reclassified when characteristics
develop
MDS-U
Increased frequency of specific
inherited mutation
○RUNX1
○SOS1
○GATA2
○ANKRD26
childhood MDS
