The combined examination of blood smears, bone marrow aspirate smears, and biopsy(ies) is paramount in diagnosing and classifying MDS. Evaluating the presence of abnormal cytogenetics is also valuable.
The bone marrow aspirate and biopsy showed increased cellularity with granulocytic proliferation. The dysplastic features in MDS are observed in one or more myeloid cell lines. The recommended requisite percentage of cells manifesting dysplasia to qualify as significant is 10% of the specific cell line. Definitions of cellular dysplasias found in MDS are as follows:
- Dysplastic erythroid cell line (due to dyserythropoiesis)
- Dysplastic granulocytic cell line (due to dysgranulopoiesis)
- Dysplastic megakaryocytic (due to dysmegakaryopoiesis)
