Myelodysplastic syndromes
Alerts and Notices
Synopsis
The peripheral blood smear usually demonstrates low cell counts (ie, anemia, thrombocytopenia, leukocytopenia) and dysplastic features in RBCs (basophilic stippling, megaloblastic changes, etc) and/or WBCs (hyposegmented or hypersegmented granulocytes, hypogranularity, etc).
The bone marrow aspirate and biopsy will usually show hypercellularity, as well as single- or multi-lineage dysplasia. Maturing RBCs may show nuclear budding, irregularity, or bridging. Ring sideroblasts may be seen. Megakaryocytes may show hypolobulation of the nucleus. Myeloblasts may be present; however, they must comprise less than 20% of cells. Certain cytogenetic abnormalities may also be present that can determine the subtype of MDS.
Depending on MDS subtype, patients may be at higher risk of developing acute myeloid leukemia (AML).
Codes
ICD10CM:D46.9 – Myelodysplastic syndrome, unspecified
SNOMEDCT:
109995007 – Myelodysplastic syndrome
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
- Poor nutritional status can lead to dysplastic features of blood cells. Causes include copper deficiency, zinc excess, vitamin B12 deficiency, folate deficiency, and alcohol use disorder.
- Certain medications can mimic MDS findings.
- Inherited disorders such as sideroblastic anemia may present with similar abnormalities.
- HIV infection
- Aplastic anemia
- AML
- Chronic myelogenous leukemia (CML)
- Myelofibrosis
- VEXAS syndrome
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
Subscription Required
Last Reviewed:01/18/2018
Last Updated:07/26/2021
Last Updated:07/26/2021