Chronic Myeloid Neoplasms
Refractory Cytopenia with Multilineage Dysplasia (RCMD)
Reviewer: Nikhil Sangle, M.D. (see Reviewers page)
Revised: 5 February 2012, last major update August 2011
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.
● Cytopenia of 2-3 lineages and dysplastic changes in ≥10% of cells of 2-3 lineages, <5% myeloblasts in bone marrow and peripheral blood
● More aggressive than refractory anemia, 10% progress to acute leukemia at two years; median survival 30 months
● Some consider it an intermediate disorder between refractory anemia and refractory anemia with excess blasts
● Poor prognosis if even 1% blasts in peripheral blood (Leuk Res 2008;32:33)
● Proposed modified criteria are refractory anemia, >10% pseudo-Pelger-Huet anomalies, dysmegakaryopoiesis in ≥40% or micromegakaryocytes in ≥10%, and no 5q- syndrome (Leukemia 2007;21:678)
● Termed RCMD with ringed sideroblasts if ≥15% ringed sideroblasts (RCMD can have a variable number of ring sideroblasts)
● Associated with chloramphenicol and responsive to cyclosporine
(Eur J Haematol 2006;76:255)
● Possibly splenectomy
(Rom J Intern Med 2007;45:89)
● Peripheral blood: cytopenia of 2-3 lineages, no/rare blasts, no Auer rods, < 1 billion/L monocytes
● Bone marrow: dysplastic changes in 10% of cells of 2-3 lineages, <5% myeloblasts in bone marrow, no Auer rods
● Refractory anemia: no dysplastic changes in granulocytes, platelets or megakaryocytes
● Refractory anemia with excess blasts: myeloblasts >5%
End of Chronic Myeloid Neoplasms > Myelodysplastic syndromes > Refractory Cytopenia with Multilineage Dysplasia (RCMD)
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