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The myelodysplastic syndromes (MDS) Aquired Clonal disease of BM . comprise a heterogeneous group of malignant stem cell disorders characterized by : 1 -d ysplastic 2 - I neffective blood cell production . ………………… . (ie, apoptotic death) .
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The myelodysplastic syndromes (MDS) Aquired Clonal disease of BM . comprise a heterogeneous group of malignant stem cell disorders characterized by : 1-dysplastic 2-Ineffective blood cell production . ………………….(ie, apoptotic death) . 3- Variable risk of transformation to …………………………..acute leukemia ( AML ). These disorders may occur de novo or arise years after exposure to potentially mutagenic chemotherapy and Iradiation.
MDS Subtypes -Refractory anemia (RA) -RA with Ring Sideroblasts ( RARS) -RA with excess blasts (RAEB) -RAEB in Transformation (REABt) -Chronic Myelomonocytic leukemia
Risk Factors of MDS • Down’s syndrome • Previous Chemotherapy • Chemical Exposure ( eg Benzene ) • Iradiation
CLINICAL PRESENTATION of MDS : peripheral cytopenias (ie, anemia, neutropenia, and thrombocytopenia) Many patients are asymptomatic, with a diagnosis established upon routine laboratory screening. fatigue, weakness, exercise intoleranceangina, dizziness Less commonly, infection, easybruising or bleeding .
Clinical features of MDS -Asymtomatic with Macrocytic anemia -Symptomatic anemia -Infections. (Neutropenia) -Hemorrhagic manifestation -General symptom. (weight loss , sweats…)
FAB Classification of MDS MDS FAB Subtype Blood Marrow blasts % RA Mono<1% Blast 1% <5% RARS Mono<1% Blast<1% <5% RAEB Blast<5% 5-20% RAEBt Blast Variable 20-30% Cmml Mono>5% Blast,5% <5%