Clinicopathological analysis of myelodysplastic syndrome according to French-American-British classification

To evaluate the age of onset, gender ratio, clinical presentation of Myelodysplastic syndrome patients, and to classify these patients according to French-American-British classification on the basis of morphological features in blood and bone marrow.

A case series.

The Department of Haematology, Shaikh Zayed Hospital, Lahore, from April 2004 to March, 2007.

Fifty patients of primary Myelodysplastic syndrome (MDS) were studied. The patients were classified according to French-American-British (FAB) criteria and the epidemiological, clinical and haematological features of MDS patients were evaluated. Descriptive statistics were used to describe data.

There were 31 males and 19 females. The mean age was 41 years. According to FAB classification, 39 cases of refractory anaemia, 1 case of refractory anaemia with ring sideroblast, 6 cases of refractory anaemia with excess of blasts and 4 cases of refractory anaemia with excess of blasts in transformation were identified. The commonest complaint was easy fatiguability affecting 41 cases (82%). Anaemia was the most common finding seen in 47 patients (94%). Pancytopenia was seen in 33 cases (66%). Dyserythropoeisis was present in 42 (84%); dysmyelopoeisis was seen in 21 (42%) and morphologically abnormal megakaryocytes were identified in 29 (58%) of the bone marrow aspirates. Grade- III reticulosis was seen in 9 bone marrow trephine biopsies. Abnormal localization of immature precursors (ALIP) were present in 18 cases.

MDS was more frequent in young males. Refractory anaemia constituted a major chunk of the disease entity.