After completing this chapter, the student will be able to:

1. Define the myelodysplastic syndromes (MDSs).

2. Outline the possible causes of the MDSs.

3. Discuss the major cellular morphological abnormalities associated with MDSs.

4. Classify MDSs according to the World Health Organization.

5. List the disease indicators that contributed to prognosis of the MDSs.

6. Discuss the management of the MDSs.

220 Part III • White Cell Disorders

The myelodysplastic syndromes (MDSs) are a group of hematology disorders that have eluded a firm designation for many decades. These disorders have been known by several other names, including preleukemia, dysmyelopoietic syndrome, oligoblastic leukemia, and the refractory anemias. In the past 20 years, considerable information has developed concerning the hema-tology of these disorders, the molecular biology, and the treatment protocols for patients with an MDS. What began as a group of cases with vague symptoms and morphology has become a recognized entity complete with classification and well-defined characteristics. Presently, 1 in 500 individuals over the age of 60 have an MDS, and it represents the most common hemato-logical malignancy in this age group.1

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