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Myelodysplastic Syndrome D006

Last amended 
4 April 2016
Current RMA Instruments
Consolidated RH SOP
73 of 2015 as amended by 35 of 2016
Consolidated BOP SOP
74 of 2015 as amended by 36 of 2016
Changes from previous Instruments

SOP Bulletin 188

ICD Coding
  • ICD-9-CM Codes: 238.70
  • ICD-10-AM Codes: D46
Brief description:

Myelodysplastic syndrome (MDS) is a group of disorders in which there is ineffective production (dysplasia) of blood cells. There are several different types, which vary in severity and the degree to which normal blood cell production is affected.

This is not a malignant neoplasm.

Confirming the diagnosis:

The diagnosis may be suspected based on a routine blood count and blood film, but a bone marrow biopsy is needed for confirmation.

The relevant medical specialist is a haematologist.

Additional diagnoses covered by these SOPs
  • Myelodysplastic disorder
  • Refactory cytopaenia with unilineage dysplasia (RCUD)
  • Refractory cytopaenia with multilineage dysplasia (RCMD)
  • Refractory anaemia with ring sideroblasts (RARS)
  • Refractory anaemia with excess blasts (RAEB)
  • Myelodysplastic syndrome unclassified.
Conditions not covered by these SOPs
  • Acute myeloblastic leukaemia*  Acute myeloid leukaemia
  • Acute promyelocytic leukaemia*  Acute myeloid leukaemia
  • Acute myelomonocytic leukaemia*  Acute myeloid leukaemia
  • Acute panmyelosis with myelofibrosis*  Acute myeloid leukaemia
  • Myelodysplasia of the spinal cord#
  • Myeloid sarcoma*  Acute myeloid leukaemia
  • Aplastic anaemia*
  • Immune thrombocytopaenic purpura*                                      

* another SOP applies  - the SOP has the same name unless otherwise specified

# non-SOP condition

Clinical onset

The clinical onset will generally be at or shortly before the time of diagnosis. The condition is often asymptomatic and discovered incidentally on a routine blood test performed for another purpose.  However, the condition can produce symptoms due to a lack of red blood cells (anaemia) manifesting with weakness or fatigue; symptoms due to a lack of platelets (thrombocytopaenia) manifesting with pinpoint haemorrhages (petechiae) or spots of haemorrhage (purpura) of the skin and mucous membranes; or symptoms due to a lack of white cells (neutropaenia) manifesting as increased number of infections and occurrence of uncommon infections.

Clinical worsening

The natural history of myelodysplastic syndrome is to worsen or to eventually transform to acute myeloid leukaemia (AML).  Such a transformation represents new onset of AML rather than worsening of MDS. There are no clinical worsening factors in the SOP apart from inability to obtain appropriate clinical management.  Treatment can be effective in controlling symptoms and prolonging survival, so lack of appropriate treatment could result in a worsening of the condition.

Comments on SOP factors

Undergoing treatment with radioactive iodine or phosphorus does not include diagnostic tests where these agents are used as tracers.