A study of clinical, hematological and histomorphological profile of myelodysplastic syndromes
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2016, Vol 20, Issue 2
Abstract
Background: Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by cytopenias, dysplasias, ineffective hematopoiesis and cytogenetic abnormalities with risk of transformation to acute myeloid leukemia. They have been classified into subtypes initially by the FAB scheme and later as per the WHO classification. Objective: To study the clinical, hematological and histomorphological features of patients diagnosed to have primary MDS. Methods: 30 adult cases of myelodysplastic syndrome were enrolled after excluding secondary causes of dysplasia, and their clinical, hematological and bone marrow morphology profiles were studied. They were classified into various subtypes according to the French-American-British (FAB) classification and the WHO 2008 classification. Cytogenetic profile could be done for 4 patients who were prognosticated according to IPSS scoring system. Results: The median age of MDS occurrence was 52 years. Male to female ratio of patients was 1.72:1. All patients had anemia. Leucopenia was seen in 12 cases (40%) and thrombocytopenia was seen in 16 (53.3%) patients. 10 patients had fever while 8 patients presented with bleeding symptoms. Refractory cytopenia with unilineage dysplasia (RCUD) was the commonest subtype (33.3%) of MDS followed by MDS-U as per WHO classification in our study, whereas as per FAB classification, Refractory Anemia (53.3%) was the commonest subtype. There were 5 cases of CMML. One patient had del (5q). There were no cases of RAEB-T. 96.6% patients had dyserythropoiesis, 46.6% had dysmyelopoiesis and 53.3% had dysmegakarypoiesis. Myelofibrosis was observed in 3 cases. Conclusions: MDS seems to occur earlier in Indian patients as seen in our study and in other Indian studies on MDS. The diagnosis of MDS remains a challenging one and so is the treatment. Cytogenetic analysis should be made more readily available and affordable to be able to prognosticate patients more accurately. Keywords: Myelodysplastic Syndrome; Dysplasia; Cytopenias; Cytogenetics.
Authors and Affiliations
Pramod Darole, Sameer Yadav, Lalit Raut, Namita Padwal, Nivedita Moulick
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