Dysmyelopoietic features and bone marrow histology in 30 cases of primary myelodysplastic syndromes

Thirty cases of primary myelodysplastic syndromes (MDS) were diagnosed according to the FAB criteria. The age ranged between 5-78 years, the median age being 38 years. Twelve (40%) patients were younger than 30 years of age. Male female ratio was 2:1. Nine cases each were diagnosed as refractory anaemia (RA) and refractory anaemia with excess of blasts (RAEB) whereas 12 were diagnosed as RAEB in transformation (RAEB-T). Significantly more RA and RAEB-T cases showed dyserythropoietic features when compared to RAEB. The frequency of dysgranulopoiesis and dysmegakaryopoiesis was similar in all 3 FAB subgroups. Abnormal localisation of immature precursors (ALIP) was present in only 36.6% of the patients and was seen in 58.3% of RAEB-T. When present it appeared to indicate a worse prognosis. Six of the 12 cases showing this finding progressed either to acute myeloblastic leukemia or from RA to RAEB or RAEB-T.