Page 234 - Essential Haematology

220 / Chapter 16 Myelodysplasia

Step 1
Determine the presence of dysplasia?

Step 2
Are bone marrow blasts > 20%?

Yes No
AML Step 3
9
Are monocytes > 1 x 10 /L?
Yes No

Chronic myelomonocytic leukaemia Step 4
MDS/MP What is the percentage of blasts?

10–19% 5–9% < 5%

RAEB 2 RAEB 1 Step 5
Is there del(5q) on cytogenetics?

Yes No
MDS del(5q) Step 6
What is the percentage of
ring sideroblasts?

> 15% < 15%

Multilineage dysplasia? Multilineage dysplasia?
(2 or more cell lines with (2 or more cell lines with
> 10% dysplasia) > 10% dysplasia)

Yes No Yes No
Refractory Refractory Refractory Refractory
cytopenia with anaemia anaemia with anaemia
multilineage with ring multilineage
dysplasia sideroblasts dysplasia

Figure 16.3 Approach to the diagnosis of myelodysplasia. MP, myeloproliferative. (Based on Bennett J.M. and
Komrokji R.S. (2006) Hematology 10 , Suppl 1:258 – 69.)