Bone marrow histology in myelodysplastic syndromes

Bone biopsies of 300 patients with myelodysplastic syndromes (MDS) were studied. The bone marrow findings fell into one of six categories: 1. MDS sideroblastic; 2. MDS megaloblastoid; 3. MDS proliferative; 4. MDS blastic; 5. MDS inflammatory; 6. MDS hypoplastic, which were then correlated with defined clinical entities. A comparison was made between the findings in bone marrow histology and the groups of the FAB classification based on aspirate cytology. No correspondence was found between the 5 groups of the FAB classification and the histological categories. The possible underlying bone marrow histologies for the FAB subgroups are given. Follow-up and sequential biopsies were used to establish the subsequent clinical course for each of the histological categories. The conclusion is drawn that aspirate cytology and bone marrow histology are complementary procedures and that both are required for the diagnosis and evaluation of prognosis in patients with MDS.