The chosen diagnostic criterion of MDS is the dysplasia in ≥10% of total count, this morphology features can point to underlying pathological cytogenetic changes which suggestive MDS diagnosis according to the World Health Organization (WHO) 2016 revision. The age of MDS patients at diagnosis was different according to residency the results of some studies on patients show that the median age of diagnosis in German, Japan, and Korea were 74, 60, and 57 years, respectively. The risk of MDS increased with advancing age approximately 86% of patients with newly diagnosed MDS predominate in the elderly, with a median age at diagnosis 65 years. This score suggests that patients with unilineage erythroid dysplasia do not need transfusion. The updated and recent scoring system combine with WHO classification for identification transfusion need was modified by Malcovati and co-workers, the so-called WPSS (World Prognostic Scoring System). The International Prognostic Scoring System (IPSS) is based on a multivariate to evaluate the prognosis. The WHO classification system uses percentages of blasts in bone marrow, ring sideroblasts and dysplastic changes to differentiate MDS subtypes. French-American-British (FAB) classification was recommended in early and as modified by the World Health Organization (WHO). In the last 20 years, different MDS classification and prognostic scoring systems have been proposed. MDS incidence increased from less than 5/100,000 for patients less than 60 years to 36.2 per 100,000 in patients more than 80 year old and more common among men. The risks of MDS include infection, anemia, bleeding and transformation to acute myeloblastic leukemia (AML) in approximately 30% of cases. MDS have been recognized for more than 70 years and named refractory anemia, oligoblastic leukemia and smoldering acute leukemia. Myelodysplastic syndromes (MDS) are clonal stem cell disorders with a relatively heterogeneous spectrum, characterized by morphological dysplasia in hematopoietic cells and by bone marrow failure and varying degrees of peripheral blood cytopenias. The correct morphological interpretation and the use of cytogenetics, immunophenotyping, immunohistochemistry and molecular analysis will give valuable information on diagnosis and prognosis. The strategy of diagnostic laboratory in MDS depends on morphological changes and is based on existence of dysplastic changes in the peripheral blood and bone marrow including peripheral blood smear, bone marrow aspirate smear and bone marrow trephine biopsy. French-American-British (FAB) classification proposed a classification based on easily obtainable laboratory information and was recommended in early and as modified by guidelines of new classification of World Health Organization (WHO). MDS diagnosis and classification present important challenges, particularly in the distinction from benign conditions. ![]() Presentation of MDS can range from asymptomatic to life threatening. MDS can present with varying degrees of single or multiple cytopenias including neutropenia, anemia and thrombocytopenia. Myelodysplastic syndrome (MDS) is a clonal hematopoietic stem cell disorder characterized by morphological dysplastic changes in one or more of the major hematopoietic cell lines.
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