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9 - Grade/differentiation unknown, not stated, or not applicable
Acquired idiopathic sideroblastic anemia
Pure sideroblastic anemia
Refractory anemia with hemochromatosis
Refractory anemia with ring sideroblasts associated with marked thrombocytosis
Refractory anemia with ringed sideroblasts
Refractory anemia with sideroblasts
> or equal to 15% ringed sideroblasts in marrow < 5% myeloblasts in marrow, not in blood Erythroid dysplasia
The principle sites of involvement are the peripheral blood and bone marrow. The peripheral blood may contain a minor population of hypochromic cells but will not show blasts. The bone marrow aspirate smear shows an increase in erythroid precursors with erythroid lineage dysplasia. People with RA with ring sideroblasts are similar to those with refractory anemia except that many of the red blood cells in the bone marrow contain characteristic ring-shaped iron deposits which are called ring sideroblasts. About 10% to 15% of all people with MDS have this type. This type rarely turns into leukemia, and the outcome is generally the same as with refractory anemia. Only 1-2% of cases progress to AML.
MDS is a group name for a number of specific diseases. As the MDS progresses, it may manifest as several subtypes. This is a part of the disease process. Abstracting each of the subtypes would result in over-counting these diseases. Code the first subtype that is diagnosed. Do not change the histology code or create a new abstract for any subsequent specific MDS subtypes.