Refractory Cytopenia with Multilineage Dysplasia (RCMD) is one of the myelodysplastic syndromes defined by the WHO.


Patients are typically elderly.



(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



(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.



• Some patients progress to acute leukemia.

• The median survival for both RCMD and RCMD-RS is about 33 months.


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