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.
D46.9 – Myelodysplastic syndrome, unspecified
109995007 – Myelodysplastic syndrome
- 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.
- Human immunodeficiency virus (HIV) infection
- Aplastic anemia
- Acute myelogenous leukemia (AML)
- Chronic myelogenous leukemia (CML)
Last Updated: 01/19/2018