Patients are typically elderly.
Features:
(1) cytopenias in 2 or 3 marrow cell lines (bicytopenia or pancytopenia)
(2) dysplastic changes in >= 10% of cells from at least 2 cell lines in the marrow
(3) < 1% blasts in the peripheral blood
(4) < 5% blasts in the bone marrow
(5) Auer rods are absent
Exclusions:
(1) >= 15% ringed sideroblasts (see below)
(2) absolute monocyte count >= 1,000 per µL
(3) >= 5% blasts in the bone marrow
(4) presence of Auer rods
Refractory cytopenia with multilineage dysplasia with ringed sideroblasts (RCMD-RS) meets the criteria for RCMD but has >= 15% ringed sideroblasts.
Prognosis:
• Some patients progress to acute leukemia.
• The median survival for both RCMD and RCMD-RS is about 33 months.
