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Pathology of Myelodysplastic Syndrome with Multilineage Dysplasia


Myelodysplastic syndrome with multilineage dysplasia (MDS-MLD) is one of the more common myelodysplastic syndromes (MDS). MDS are clonal disorders of myeloid stem cells. These syndromes are characterized by ineffective hematopoiesis manifested in morphologic dysplasia of hematopoietic precursors, one or more peripheral blood cytopenias, and a propensity to progress to acute myeloid leukemia (AML).

The 2016 update to the fourth edition of the World Health Organization (WHO) Classification of Tumors of the Hematopoietic and Lymphoid Tissues renamed the entity previously diagnosed as refractory cytopenia with multilineage dysplasia (RCMD) as MDS-MLD, in part because the presence of a specific cytopenia (eg, anemia) does not necessarily correlate with the degree or type of dysplasia seen in the bone marrow and peripheral blood.

On the basis of the 2016 WHO classification update, MDS include the following disorders


MDS with single lineage dysplasia

MDS with ring sideroblasts (MDS-RS), which are further subclassified into MDS-RS and single lineage dysplasia and MDS-RS and multilineage dysplasia

MDS with excess blasts

MDS with isolated del(5q)

MD, unclassifiable

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