Myelodysplastic syndromes

These conditions have been recognised under a variety of names, such as 'refractory anaemia' and 'preleukaemia', for a long time, but only relatively recently have they been grouped together. They are quite common in the elderly but may be seen in any age group (refer Table 19.2 ). These conditions frequently present as a macrocytic anaemia with normal serum B12 and red cell folate, and are unresponsive to these or any other haematinics; they are usually associated with progressive intractable neutropenia or thrombocytopenia or both, and progress slowly but relentlessly to be eventually fatal, terminating with infection, haemorrhage or, less often, acute leukaemia.

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