ABSTRACT
The current diagnostic approach to patients with MDS includes a combination of clinical history, complete blood count (CBC) data, blood and bone marrow cytomorphology, iron stain, histomorphology and cytogenetics/fluorescence in situ hybridization studies. Routine FC does not include the evaluation of red cell precursors for features of dyserythropoiesis as they are lysed together with red blood cells during sample preparation, or megakaryocytes which are too scanty to be harvested for analysis. Low grade MDS tends to have less obvious changes, whereas high grade MDS shows more pronounced changes. Differential Diagnosis Abnormal granulocytes with low SSC have to be differentiated from other neoplastic cells with moderate CD45 and low SSC including blasts, monocytes, hypogranular variant of acute promyelocytic leukemia, leftward-shifted maturing precursors, and large cell lymphomas. Loosdrecht et al. reported the median percentage of myeloid progenitor cells of 2.4% in MDS patients compared to 1.2% in normal bone marrow samples.
