Analysis on Characteristics of Dysplasia in 345 Patients with Myelodysplastic Syndrome

Objective To investigate the characteristics of dysplasia in myelodysplastic syndrome (MDS).

Methods Collect 716 samples of adult patients with abnormal blood routine but unclear cause between July 04, 2003 and March 14, 2007. Based on the gold standard of WHO MDS classification, all cases were detected on cytomorphological observation, cytochemical stain, bone marrow pathological study, cytogenetics, flow cytometry, and ect. The bone marrow cytological study on some abnormal hematopoietic cells has a diagnostic value to determine clonal or non-clonal diseases and assess sensitivity and specificity.

Results In the complicated various dysplasia of hematopoietic cells, the following characteristics can be the main basis of cytomorphological diagnosis:

1. One of granular Auer bodies, micronucleus (MN), or nuclear budding;

2. Erythroid nuclear budding;

3. Megakaryocytes presented in peripheral blood;

4. Myeloblast or prorubricyte exhibited in peripheral blood;

5. ringed sideroblasts>1%.

The subordinate basis of cytomorphological diagnosis was as follows:

1. Granular pseudo Pelger-H≥et anomaly, hard nucleus segmentation, unsynchronous development of nuclei, ring-shaped nuclei, and aggregation of nuclear chromatin.

2. Erythroid multi-nuclei, odd nucleus, mother-daughter nucleus, nuclear fragmentation, vacuole, and anisocytosis;

3. micromegakaryocytes.

Conclusion Cytomorphologic is the base for the diagnosis of MDS, however, it presents certain limit, especially cytomorphological change does not possess specificity for early MDS, hereby, it requires to combine other detection methods.