![]() Keeping this in mind, this study was done to assess the baseline clinicohematological characteristics of patients presenting with MDS, evaluate their cytogenetic profile and compare our analysis to what has been reported previously. Impact of racial difference on disease biology and clinical behavior was evaluated in previous Asian study but has not been well established. Thus most of the cases of refractory cytopenias are not diagnosed for MDS. However in developing countries like Pakistan, with poor socioeconomic status of patients, clinicians have very limited availability of sophisticated techniques like cytogenetics inspite of this being incorporated as mandatory tool for the diagnosis. Thus the role of cytogenetics with respect to diagnosis and prognosis has been well established in this clonal disorder. Consensus International Prognostic Scoring System (IPSS) is used for predicting outcome and planning therapy in MDS which includes number of cytopenias, percentage of bone marrow blast and cytogenetics. The disease can be classified into primary (de novo) and secondary MDS, whether it is de novo or arise as result of previous radiochemical exposure. However, proposed pathogenic causes include increased apoptosis, immunological abnormalities along with clonal basis. The exact pathogenesis is not completely understood. Myelodysplastic syndromes (MDS) are group of clonal hematopoietic stem cell disorders exhibiting ineffective hematopoiesis, morphological dysplasia and progressive tendency to evolve into acute myeloid leukemia (AML). This is the largest cohort of patients of MDS evaluated for baseline clinical and cytogenetic characteristics in our country. Monosomy 7 being associated with bad overall survival, such patients must be identified early with close clinical follow up and offered stem cell transplant. CK and monosomy 7 carry bad prognostic implications and early disease transformation to acute myeloid leukemia (AML). We found younger median age at diagnosis, higher mean TLC and no significant history of recurrent infections. ![]() Karyotype was done in 98 (55%) patients out of which 44 (45%) had abnormal karyotype, complex karyotype (CK) was most commonly observed in 12 (12.2%) followed by monosomy 7 in 7 (7.1%). Refractory cytopenias with multilineage dysplasia (RCMD) was the most common world health organization (WHO) category. Of total 170 (96%) were transfusion dependent. Pancytopenia was observed in 80 (45%) patients and bicytopenia in 74 (42%). Total of 177 patients were included in the study having median age 51 years and male to female ratio of 3:1. ResultsĪ retrospective cross sectional study was done at National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan from 2010 to 2016. The aim of the study was to study baseline clinicohematological and cytogenetic characteristics of patients presenting with de novo MDS. Bone marrow cytogenetics, inspite of being incorporated as mandatory tool in diagnosis are done less frequently due to limited availability of this technique in Pakistan. Myelodysplastic syndromes (MDS) are clonal stem cell disorders exhibiting cytopenias, ineffective hematopoiesis and morphological dysplasia.
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