NCCN Guidelines for Patients® | Myelodysplastic Syndromes
16 NCCN Guidelines for Patients ® : Myelodysplastic Syndromes, 2018 2 Testing for MDS Physical exam | Blood tests Physical exam Doctors usually perform a physical exam along with taking a medical history. A physical exam is a review of your body for signs of disease such as infection and areas of unusual bleeding or bruising. Your doctor may listen to your lungs, heart, and intestines. Your doctor may also feel different parts of your body to see if organs are of normal size, are soft or hard, or cause pain when touched. Blood tests Doctors test blood to look for signs of disease and to check your general health. Blood tests are done along with other initial tests to help diagnose MDS. For a blood test, your doctor will insert a needle into a vein to remove a sample of blood. The blood sample will then be sent to a lab for testing. At the lab, a pathologist will examine the blood sample with a microscope and perform other tests. CBC with differential CBC is a test that measures the number of blood cells in a blood sample. It includes the number of white blood cells, red blood cells, and platelets. Patients with MDS often have a low number of one or more types of blood cells. A low number of blood cells is called a cytopenia. The CBC should include a differential. The differential measures the different types of white blood cells in the sample. Some types of white blood cells include neutrophils, monocytes, and lymphocytes. A CBC with differential is given with other tests when MDS is first suspected. This test is not used alone to diagnose MDS, but it can tell your doctor about your overall health. It will show if you have the right number of healthy red blood cells, white blood cells, and platelets. It can also guide other tests that may be needed to find out why blood cell counts are low. Reticulocyte count Reticulocytes are younger (precursor) cells that become mature red blood cells. The reticulocyte count is a measure of the number of reticulocytes in the bloodstream. It reflects how quickly reticulocytes are being made and released by the bone marrow. This test is used to show if your bone marrow is making the right number of new red blood cells. It can also help doctors find out the cause of anemia. Anemia is a low number of healthy red blood cells in the bloodstream. The body’s normal response to anemia is for the bone marrow to make more reticulocytes. A low reticulocyte count is a sign that the bone marrow isn’t working well. Blood smear For a blood smear, a drop of blood is placed on a slide so it can be viewed with a microscope. A pathologist will assess the size, shape, type, and maturity of the blood cells. This test can help count the different types of blood cells in a sample. It is also used to look for defects in blood cells such as an abnormal shape or size (dysplasia). A key feature of MDS is that is causes blood cells to look abnormal. This test may also be used to check for blast cells in the bloodstream. Normally, blast cells are only found in the bone marrow. But, in some cases of MDS, a small number of blast cells may be found in the bloodstream. Other tests are done to assess the cause of low blood cell counts. A number of health conditions can also cause a low number of red blood cells and other problems similar to MDS. To confirm MDS, more blood tests will be done to rule out other health conditions. The main tests that may be used to learn more about the cause of low blood cell counts are described next.