The role of bone marrow study in diagnosis and prognosis of myelodysplastic syndrome.

In this study, cases of myelodysplasia diagnosed in a brazilian population are reported. Some differences such as a higher number of cases of hypocellular bone marrow (45.6%) were observed. There was no significant difference between patients that developed acute leukemia or not, when some bone marrow parameters such as cellularity, abnormality in reticulin fibers presence of atypically located immature precursors (ALIP), quantitative and qualitative changes of erythroblastic, granulocytic and megakaryocitic series were compared. There was no correlation either between ALIP and excess of blasts in cytology, or between FAB classification and bone marrow histology. Patients with hypocellular marrow presented lower frequency of atypic megakaryocitc than patients with normo or hypercellular bone marrow and a shorter, although not statistically significant survival. The survival of patients with ALIP was significantly lower than of those without ALIP. Cases of RAEB had a worse prognosis when compared to RA. Bone marrow histology had an important role in the differential diagnosis between MDS with hypoplastic marrow and aplastic anemia.