APPLICATION OF NEW CRITERIA TO RECLASSIFY A CASE OF MDS-EB AND ERYTHROID PREDOMINANCE WITH COMPLEX KARYOTYPE

This article reports an interesting case of a 63-year-old woman with no previous medical history who presented with non-specific symptoms and pancytopenia and was diagnosed with myelodysplastic syndrome with excess blasts (MDS-EB). The paper provides a detailed description of the patient’s clinical and laboratory findings, including peripheral blood, bone marrow aspirate, and trephine biopsy. The report highlights the differences in the classification of myeloid neoplasms between the current WHO-HAEM4R (2017), the previous edition (WHO -HAEM4 [2008]), and the forthcoming WHO-HAEM5 and ICC. The case is significant as it illustrates the characteristic morphology, diagnostic investigations, and the importance of comprehensive risk stratification in MDS-EB. The case reported here has a complex karyotype with five chromosomal abnormalities, which underlines the poor outcome of this entity. This article also discusses the proposed change in nomenclature from MDS-EB to MDS with increased blast percentage (MDS-IB) and ‘myelodysplastic neoplasm’ replacing the term ‘myelodysplastic syndrome’ in the forthcoming WHO classification (WHO-HAEM5) and why this case may be better classified using WHO-HAEM5.