Chronic Myeloid Neoplasms
Myelodysplastic syndromes
Refractory Cytopenia with Multilineage Dysplasia (RCMD)

Author: Nikhil Sangle, M.D. (see Authors page)

Revised: 2 March 2017, last major update August 2011

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PubMed Search: Refractory Cytopenia with Multilineage Dysplasia (RCMD)

Cite this page: Refractory Cytopenia with Multilineage Dysplasia (RCMD). PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/myeloproliferativeRCMD.html. Accessed April 29th, 2017.
Clinical features
  • 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)
Case reports
Treatment
Microscopic (histologic) description
  • 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
Microscopic (histologic) images

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Various images

Differential diagnosis