Objective: To study the origin and progress of myelodysplastic syndrome (MDS) with hypoplasia.
Methods: The data of twenty-five cases of hypomyeloplastic MDS diagnosed by our department in the last ten years were analyzed. 17 of the 25 cases were followed up for a long time.
Results: (1) The percentage of hypomyeloplastic MDS was 11.4% of the total 219 MDS patients. The median age of the 25 cases was (44.8 +/- 14.7) years. (2) FAB subtype: There were 11 cases of RA and 14 of RAEB. (3) Hypomyeloplastic MDS seems to be a developmental phase in the clinical course in some of the patients and not a special type of MDS. Hyper- and hypo-myeloplasia could be transformed from one to another. The transformation of myelodysplasia could occur either in the same or and different FAB subtype. (4) Seven of the seventeen cases transformed to acute leukemia (41.2%), 6 cases were AML and 1 was ALL. 3 of the 7 cases transformed to hypomyeloplastic leukemia and the remaining 4 transformed to hypermyeloplastic leukemia. (5) The median time from the diagnosis of RAEB to leukemia transformation, was 27 months in 7 cases with hypoplastic RAEB. (6) No relationship was found between therapeutic medicines and development of hypomyeloplastic MDS.
Conclusion: It is suggested that hypomyeloplastic MDS is probably a developmental phase in the clinical course of MDS, but not a special type.