ABSTRACT
I. INTRODUCTION The first published reports (1-7), dating back to at least 1913, of what is now designated the myelodysplastic syndromes (MDS) were individual case reports and single-institution case series of refractory anemia. The reports usually contained detailed case information describing characteristic presenting symptoms, physical examination findings, peripheral blood film findings, bone marrow morphology as determined through biopsy, and clinical outcome. Typically, individuals were reported as presenting with fatigue and pallor and were found to have anemia that did not respond to ‘‘hematinic’’ treatment. Peripheral blood films typically showed red cell anisocytosis. Bone marrow biopsies showed unexpected erythroid lineage hypercellularity. When long-term follow-up was reported, progression to trilineage peripheral blood dysplasia was described. Final outcome in the early case reports was usually death from progressive anemia, hemorrhage, infection, or acute leukemia.
