myelodysplastic syndromes chapter 33

dyserythropoiesis peripheral blood findings

oval macrocytes, hypochromic microcytes, basophilic stippling, howell jolly, siderocytes

dyserythropoiesis bone marrow findings

RBC precursors with more than one nucleus, basophilic stippling

dysmyelopoiesis peripheral blood findings

nuclear cytoplasm asynchrony, abnormal granulation, nuclear rings

dysmyelopoiesis bone marrow findings

nuclear cytoplasm asynchrony, uneven staining

dysmegakaryopoiesis peripheral blood findings

giant platelets

dysmegakaryopoiesis bone marrow findings

large mononuclear megakaryocytes

refractory anemia with ring sideroblasts (RARS)

refractory cytopenia with multilineage dysplasia (RCMD)

one or more cytopenias, no auer rods

refractory anemia with excess blasts (RAEB) class 1

5-9% blasts

refractory anemia with excess blasts (RAEB) class 2

10-19% blasts, presence of auer rods

myelodysplastic syndrome with isolated del(5q) (5q-syndrome)

refractory anemia WITHOUT cytopenia

what age group does 5q syndrome mainly affect

women age 67

chronic myelomonocytic leukemia (CMML)

persistent monocytosis, lack of BCR/ABL1 gene, increased leukocytes

atypical chronic myeloid leukemia (ACML)

BCR/ABL1 negative, dysplastic neutrophils

MDS are most common in which age group

older than 50 years

what is a major indication of MDS in the peripheral blood and bone marrow

dyspoiesis

an alert hematologist should recognize all of the following peripheral blood abnormalities as diagnostic clues in MDS EXCEPT

target cells

for an erythroid precursor to be considered a ring sideroblast, the iron-aden mitochondria must encircle how much of the nucleus

one third

according to the WHO classification of MDS, what percentage of blasts would constitute transformation to an acute leukemia

20%

a patient has anemia, oval macrocytes, and hypersegmented neutrophils. which of the following tests would be most efficient in differential diagnosis of this disorder

vitamin b12 and folate levels

which of the following is LEAST likely to contribute to the death of patients with MDS

neuropathy

into what other hematologic disease does MDS often convert

AML

chronic myelomonocytic leukemia is classified in the WHO system as

MDS/MPN