Hypocellular MDS

Hypocellular MDS accounts for less than 10 to 15 percent of all cases.176,177 According to our experience,160 hypocellularity is a more common feature of MDS than AML, even after age adjustment based on normal biopsy. To recognize the clinical and morphological features of these patients, we consider bone marrow cellularity of 30 percent the upper limit, to include such cases in hypocellular MDS.

The clinical findings and the morphological features of the bone marrow may be difficult to distinguish from those associated with aplastic anemia.178 The finding of cytogenetic abnormalities that are typical of MDS permits an accurate diagnosis. However, CD34 and PCNA immunostaining can be of practical value in the absence of cytogenetic data.179 The diagnostic criteria for hypocellular MDS must be met for FAB criteria. Most cases fall into the categories of RA and RAEB. The natural history of hypocellular MDS seems to be similar to that of normo-cellular and hypocellular MDS.180,181

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