Morphology and flow cytometry

Despite the rapid development of molecular markers during the last years, the morphology of blood and bone marrow cells still keeps the crucial role for diagnosis and subclassification of the different subtypes of myelodysplastic syndromes (MDS), as recently confirmed by the new 2016 WHO classification [1]. Nevertheless, morphologic diagnosis is not always self-evident. While increased blast cells are often in-line with advanced MDS subtypes, early forms with mild morphological changes can represent a diagnostic challenge. Especially in these cases, morphologic experience is crucial but should be embedded into further information on disease history, exclusion of other underlying diseases, as well as additional cytogenetic, molecular, and immunophenotypic data to confirm diagnosis of MDS.