ABSTRACT
The myelodysplastic syndrome (MDS) describes patients with refractory cytopenias and dysplastic changes in blood and bone marrow which carry an increased risk for undergoing transformation to acute myeloid leukaemia (AML). This syndrome has been variously termed ‘preleukaemia’, ‘refractory anaemia’, ‘oligoblastic leukaemia’ or ‘smouldering leukaemia’. MDS is a clonal expansion of the multipotential haematopoietic progenitor cell [1-3] with, in some cases, involvement of the lymphoid lineage too [4]. MDS occurs mainly in elderly persons around 70 years of age [5], but in a population-based study the annual incidence of MDS was 3.4/1000000 in children
below the age of 15 years [6]. The rising incidence in recent years may reflect increased awareness of the physician and willingness to perform diagnostic procedures in elderly patients [7], but an influence of occupational and/or environmental exposure cannot be excluded. The incidence of therapy-related MDS and AML (t-MDS/t-AML) is increasing owing to better survival following irradiation or chemotherapy for primary malignancies [8,9].
