Q. What are the physical changes observed in the acute transformation of myelodysplastic disorder?

Answered by
Dr. Mubashir Razzaq Khan
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Nov 18, 2021

Hi doctor,

An elderly family member was diagnosed with overlap myeloproliferative or myelodysplastic disorder two years back. He is being treated by a hematologist who arranges regular blood tests and he is said to be "hematological stable". However, I understand that there can be an acute transformation over time and the hematologist would presumably be able to detect this. Are there any physical symptoms that the family can look for? Though he does not have now, could he get if he develops an acute transformation? His appetite has been in decline for a while. He does not experience night sweats at all and I am told that he does not have an enlarged spleen. What sort of physical changes might alert us if he develops an acute transformation? He is currently being treated with Hydroxyurea.



Welcome to

Hope you are doing well in the pandemic. The acute transformation has clinical signs and symptoms of acute leukemia, such as recurring fever not responding to antibiotics, pallor, dyspnoea, shortness of breath due to low hemoglobin, bruising and bleeding due to low platelets, loss of appetite and weight, lethargy, malaise, and generalized bone pains. Do the blood tests regularly. Keep an eye on the cytogenetic abnormalities as these appear months before physical changes. Please do not forget to give feedback in the end. All the best.

Thank you doctor,

Thank you, doctor. This is extremely useful information. There is one more point that I would like to check with you. Obviously, not all cases are the same and you are not in a position to personally treat my family member. But could you please tell me what is the average or mean period of time that people with overlap myeloproliferative or myelodysplastic disorder live from the time of diagnosis?



Welcome back to

Hey. It is good to see you again. It depends upon the baseline conditions. For example, the patient with only unilineage refractory cytopenia, with blast cells less than 1%, might take decades to evolve into a blast transformation (leading to death) if left untreated. In the case of patients having multiple cytopenias with 5 to 19%, blasts would take less than a year to develop a life-threatening disease. Please send me a baseline workup and a fresh CBC (complete blood count) report for a more elaborative comment. All the best.

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