Myelodysplastic Syndromes (MDS)

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George Girgis MLS (ASCP) CM
Reviewers: Margaret Reinhart, MT(ASCP); Leah Coppolino, MPH, MLS(ASCP)CM

This course discusses the epidemiology, etiology, and the diagnostic criteria of myelodysplastic syndromes (MDS). The classification of MDS according to the World Health Organization (WHO) guidelines is explained along with morphological features and prognosis of MDS.

Continuing Education Credits

Objectives

  • Define myelodysplastic syndromes (MDS).
  • Describe the epidemiology and etiology of MDS.
  • Explain the diagnostic criteria of MDS.
  • Describe the morphological features of MDS.
  • Explain the classification of MDS according to the World Health Organization (WHO) guidelines.
  • Discuss prognosis of MDS according to the subtypes (low, intermediate, and high grade MDS).
  • Describe the differential diagnosis of MDS.

Course Outline

  • Myelodysplastic syndromes (MDS) -- Definition, Etiology, and Epidemiology
      • Definition, Etiology, and Epidemiology
      • Myelodysplastic Syndromes (MDS) are caused by viral infections.
      • Cytotoxic agents and chemical or radiation therapy may be etiologic factors of Myelodysplastic Syndromes (MDS).
  • Clinical and Diagnostic Features of MDS
      • Clinical Features of Myelodysplastic Syndromes (MDS)
      • Diagnostic Features of MDS
      • Myelodysplastic Syndromes (MDS) are associated with microcytic/hypochromic anemia.
      • The three myeloid cell lines in the bone marrow are granulocytic, erythroid, and megakaryocytic.
      • Patients with Myelodysplastic Syndromes (MDS) commonly have enlarged liver and spleen.
      • Myelodysplastic Syndromes (MDS) are commonly associated with leukocytosis and neutrophilia in peripheral blood evaluations.
      • Patients with Myelodysplastic Syndromes (MDS) demonstrate very low vitamin B12.
  • The Morphological Features of MDS
      • The Morphological Features of Myelodysplastic Syndromes (MDS)
      • Dysplastic Erythroid Cell Line (Dyserythropoiesis)
      • Examples of Dysplastic Erythroid Cells (Dyserythropoiesis), continued
      • Dysplastic Granulocytic Cell Line (Dysgranulopoiesis)
      • Dysplastic Megakaryocytic Cell Line (Dysmegakaryopoiesis)
      • The dysplasia of the erythroid cell line may include nuclear budding, megaloblastoid, and ring sideroblasts in cases of MDS.
      • Normal megakaryocytes show multinucleation or monolobes.
      • Granulocytic dysplasia in MDS may include nuclear hyposegmentaion and/or cytoplasmic hypogranulation.
  • The Classification of MDS
      • The Classification of Myelodysplastic Syndromes (MDS)
      • The Classification of Myelodysplastic Syndromes (MDS), continued
      • The Significance of Auer Rods in MDS:
      • Myelodysplastic Syndromes (MDS) with single-line dysplasia show <5% bone marrow blasts.
      • Myelodysplastic Syndromes (MDS) with multilineage dysplasia show 10-19 % blasts in the bone marrow.
  • The Prognostic Criteria of MDS
      • Prognostic Criteria of Myelodysplastic Syndromes (MDS)
      • Myelodysplastic Syndrome (MDS) with bone marrow blasts counts of 5-9% carries a low-risk grade.
      • Myelodysplastic Syndromes (MDS) with bone marrow blast counts between 10-19% are considered to be a high-risk grade.
  • The Differential Diagnosis of MDS
      • Differential Diagnosis of MDS
      • Vitamin B12 or folate deficiencies may cause megaloblastic changes in the bone marrow and blood cytopenia.
      • Chemotherapeutic drugs cause bone marrow hyperplasia and leukocytosis.
  • MDS Therapy
      • MDS therapy
  • References
      • References

Additional Information

Level of instruction: Intermediate

Intended audience: Medical laboratory professionals, clinical laboratory science students, and instructors of hematology.
 Information: George Girgis, MLS (ASCP)CM has over 30 years of experience as a Medical Laboratory Scientist during which he has been a trainer and instructor at Indiana University Health in the field of hematology and hematopathology. George holds a Bachelor of Medicine, Bachelor of Surgery from Ein-Shams University, Cairo, Egypt and a Bachelor of Science in Medical Laboratory Sciences from I.U.P.U.I., Indianapolis, IN.
 Reviewer Information: Margaret Reinhart MS, MT(ASCP) is the MLS Program Director and Senior lecturer in Biological Sciences at the University of the Sciences in Philadelphia PA where she teaches hematology, clinical immunology, parasitology and other related courses. She is also adjunct instructor in Hematology at Pennsylvania Hospital, Philadelphia PA. She holds a Masters Degree in Biology and in Health Care Administration.
 Reviewer Information:  Leah Coppolino, MPH, MLS(ASCP)CM is the Director of Sales at MediaLab, Inc. Previously, she was the Director of the Medical Laboratory Science Program at St. Christopher’s Hospital for Children in Philadelphia, Pennsylvania. She holds a Masters in Public Health from Thomas Jefferson University.

This course is part of:
Blast with Auer rod
Hypogranular & hyposegmented neutrophil
MDS Course Normal Neutrophils
Numerous blasts (MDS-excess blasts)
microcytes_new
Sideroblasts ringed
Bone marrow with numerous blasts