Clinical features

Clinical features include: (1)

• predominantly affects elderly patients except in cases of post-chemotherapy myelodysplasia
• most common presentation is of fatigue secondary to anaemia
• less commonly, easy bruising or bleeding (usually mucosal) are seen
• not infrequently discovered incidentally
• petechiae may be seen if platelet count is low
• pallor is often noticed
• lymphadenopathy and organomegaly are not usually a feature except in patients with chronic myelomonocytic leukaemia (CMML), which is particularly associated with splenomegaly, occasionally hepatomegaly, and generalised lymphadenopathy. CMML patients with very high monocyte counts may occasionally present with nodular infiltrates, and pleural and pericardial effusions

Reference

1. Killick SB, Wiseman DH, Quek L, et al. British Society for Haematology guidelines for the diagnosis and evaluation of prognosis of adult myelodysplastic syndromes. Br J Haematol. 2021 Jul;194(2):282-93.